Oktoberfest 2014 Waiver

From BelegarthWiki

Jump to: navigation, search

Download from:

https://docs.google.com/document/d/1HLRG_yo3Mv_k_ATNfhxLYdv0DAyw0Cn2epvq9_XZI4U/edit?usp=sharing


ASSUMPTION OF RISK, RELEASE OF LIABILITY, AND PARTICIPATION AGREEMENT I, the undersigned, understand and acknowledge that the program that I am about to attend and participate in is being presented by the University of Illinois Registered Student Organization: Numenor Foam Fighting, also known as Numenor, which is a member of the national organization known as the Belegarth Medieval Combat Society. The Officers and their agents of Numenor and the Belegarth Medieval Combat Society shall collectively herein be known as Hosts. IN:________

I, the undersigned, understand that participation in the events and the practice sessions of Hosts includes strenuous physical encounters between myself and other members, training partners, agents and officers which carry a substantial risk of leading to serious physical discomfort, bodily harm, great bodily harm, permanent disfigurement or impairment, or death. IN:________

By signing this release form, I give my full consent to such contact and physical activities that may cause me bodily harm, great bodily harm, disfigurement, or death. I hereby acknowledge that I fully realize during my participation that I will always at all times have the option of withdrawing from participation in any exercise or combat, and that it is my personal responsibility to decide which exercises and combats which I will participate in. I hereby also represent that I am physically and emotionally fit to engage in these combat activities. I also acknowledge that Hosts are under no obligation to require me to prove my degree of health and fitness. I further acknowledge that by participating or engaging in training, at any time during the participation I may be exposed to a substantial risk of personal injury or death arising out of negligence, gross negligence, intentional acts or otherwise, due to the very nature of the combat activities. IN:________

I understand that the Hosts, the officers, nor their agents, warrant the fighting field or other event locations to be free from debris or other defects. I further understand that the Hosts, the officers, nor their agents do not warrant, implied or otherwise, any food, drink, or other item or service provided to me, including by independent vendors. All things provided by Host are “as is”, with no warranty or duty of care implied or expressed. IN:________

If my conduct, actions, or statements while participating in or attending are determined to be inappropriate or detrimental to the safety or well being of the other participants, I shall willingly comply with the request of the Hosts to remove myself and my effects from the site of training or combat immediately. I acknowledge that through my own actions I may be liable for injuries to Persons and/or property. IN:________

By signing this agreement and as part of the consideration for participating in attending the combat or training, it is my knowing and voluntarily stated intention to assume all risks involved in participation, and release the Hosts from any responsibilities or liability for any injury, physical or emotional, that I may sustain while participating in the entire event. I fully understand and agree that the Hosts and their agents will not be held liable for any injuries, damages, or death. IN:________

I agree for myself and successors, that the above representations are contractually binding, and are not mere recitals, and that should I or my successors assert my claim in contravention of this Agreement, I or my successors shall be liable for the expense (including but not limited to, legal fees) incurred by the other party or parties. No officer or agent has the authority to modify this agreement orally. A waiver of any provisions of the Agreement shall not be construed as a modification of any provision, or as consent to any other subsequent waiver modification. This Agreement shall be interpreted in a manner to best effectuate the intent of the parties. The provisions of this Agreement are severable. If any part of this agreement is declared invalid, the least amount possible should be declared invalid, and that declaration shall have no effect upon the part which remains. IN:________

I have read, understand, and agree to follow the Oktoberfest Codes of Conduct. IN:________

I have fully read, understand and agree to everything stated in this release form. Applicant’s Signature:_________________________________________Date:____________________________ Printed Name:__________________________________________________ D/O/B:________________________


Fighting Name:______________________________________________

                                                                           Notary Public Seal

Phone # : ( )____________________________________ Emergency Contact Name –or– Signature of Parent/Legal Guardian:______________________________________

(If applicant is under 18 years of age the Waiver must have the above signature which must be notarized) Emergency Contact –or– Legal Guardian Phone # : ( )____________________________________

Personal tools
For Fighters
For Craftsman
Leadership