Release Of Liability, Indemnity, and Assumption Of Risk, Read Before Signing

SPECIALTY INSURANCE LLC

Industry Insurance Programs

Valkyrie Airsoft LLC = VAS

Phone: (843) 751-5344

RELEASE OF LIABILITY, INDEMNITY, AND ASSUMPTION OF RISK

READ BEFORE SIGNING

IN CONSIDERATION of being permitted to participate in any Paintball and/or Airsoft activities

including, but not limited to, playing, using the premises of, renting and operating equipment leased,

sanctioned and/or operated by the above named vendor, I acknowledge and agree that:

I fully understand and acknowledge that; (a) risks and dangers exist in my use of Paintball

and/or Airsoft equipment and my participation in Paintball and/or Airsoft activities; (b) my

participation in such activities and/or use of such equipment may result in my injury or illness including

but not limited to bodily injury, disease strains, fractures, partial and/or total paralysis, eye injury,

blindness, heat stroke, heart attack, death or other ailments that could cause serious disability; (c)

these risks and dangers may be caused by the negligence of the owners, employees, officers or

agents of VAS; the negligence of the participants, the negligence of others, accidents, breaches of

contract, the forces of nature or other causes. These risks and dangers may arise from foreseeable or

unforeseeable causes; and (d) by my participation in these activities and/or use of equipment, I

hereby assume all risks and dangers and all responsibility for any losses and/or damages, whether

caused in whole or in part by the negligence or other conduct of the owners, agents, officers,

employees of VAS, or by any other person.

I, on behalf of myself, my personal representatives and my heirs, hereby voluntarily agree to

release, waive, discharge, hold harmless, defend and indemnify VAS and it’s owners, agents, officers

and employees from any and all claims, actions or losses for bodily injury, property damage

(including, but not limited to, arising out of the actual or alleged transmission of a communicable

disease), wrongful death, loss of services or otherwise which may arise out of my use of Paintball

and/or Airsoft equipment or my participation in Paintball and/or Airsoft activities. I specifically

understand that I am releasing, discharging and waiving any claims or actions that I may have

presently or in the future for the negligent acts or other conduct by the owners, agents, officers or

employees of VAS. This waiver is good through 10/20/2025.

MEDICAL PERMISSION AUTHORIZATION

If the participant is of minority age, the undersigned parent or guardian hereby gives

permission for VAS to authorize emergency medical treatment as may be deemed necessary for the

child named below while participating in Paintball and/or Airsoft games.

I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT AGREE IT IS MY INTENTION TO

EXEMPT AND RELIEVE VAS FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL

DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE.

Participants First Name:

Participants Last Name:

Age:

Date Of Birth

Phone Number:

Address:

City, State, Zip:

Signature of Parent/Guardian (if less than 18 years old) E-mail Date:

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Draw Signature
Type In Signature

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I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Adopt & Sign

Signed by Brennan Kahn
Signed On: August 14, 2024

Timestamp

Audit

March 29, 2022 10:32 am EST

Release Of Liability, Indemnity, and Assumption Of Risk, Read Before Signing Uploaded by Brennan Kahn - brennankahn@aol.com IP 76.145.250.138