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 Post subject: Official Arm V Waivers
PostPosted: Mon May 22, 2006 1:06 pm 
Mercenary
Mercenary

Joined: Sat Feb 28, 2004 10:40 am
Posts: 679
Location: Georgia
Realm: High Spires
Unit: Horde
Below is the waiver for Arm V. Notice that if you are under 18 it must be notarized. Thank you wolfpack for supplying this for everyone. So please, copy, paste, and print out everything below.


RELEASE OF LIABILITY AND TRAINING AGREEMENT

I, the undersigned, understand and acknowledge that the program that I am about to attend and participate in is being presented by Nan Belegorn Medieval Combat Club and is a member of the national organization known as Belegarth. The Officers and their agents of NBMCC shall herein be known as Hosts.

I, the undersigned, understand that participation in the events and the practice sessions of NBMCC includes possible strenuous physical encounters between myself and other training partners or officers that could lead to serious physical discomfort, and, or, permanent impairment. IN.______

By signing this release form, I give my full consent to such contact and physical activities that may cause me bodily harm or death. I hereby acknowledge that I fully realize that during the training 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 that 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 the members of NBMCC are under no obligation to require me to prove my degree of health and fitness. I further acknowledge that by entering into the training, that at any time during the training I may be exposed to a risk or personal injury or death arising out of possible negligence, unavoidable accident, or otherwise, due to the very nature of the combat activities. IN.______

I understand that NBMCC, the officers, nor their agents, warranty the fighting field to be free from debris or defects. IN.______

If my conduct, actions or statements while participating in or attending the training 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 NBMCC Officers, or their agents known as Marshals/Heralds 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 stated intention to knowingly assume all risks involved in participating in or attending these events and training, and to NBMCC, and their officers and agents from any responsibilities or liability for any injury, physical or emotional, that I may sustain while participating in or attending the training. I fully understand and agree that the Hosts and their agents will not be held liable for any injuries, damages, or death caused by or resulting from negligence of the Hosts, which is caused in whole or in part by any of my acts, including negligent acts. 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 this Agreement shall not be construed as a modification of any other provision, or as consent to any other subsequent waiver or modification. IN.______

I have fully read, understand and agree to everything stated in this release form.

Applicant?s Signature:__________________________________________Date:_________________

Printed Name:____________________________________________________________ D/O/B/_________
Last Name, First Name Middle Int.
Fighting Name:_______________________________________

Address:_____________________________________________ Notary Public Seal
_____________________________________________

Phone #: ( )__________________________

Signature or Parent/Legal Guardian:________________________________________________
(If applicant is under 18 years of age the Waiver must have the above signature which must be notarized)

VOLUNTARY MEDICAL INFORMATION
____________________________
Realm

____________________________
Fighting name

____________________________
Real World Name



The following information is completely voluntary and will be used only if there is a need to treat an injury to your person. IF YOU CHOOSE NOT TO GIVE ANY INFORMATION PLEASE PUT YOUR INITIALS HERE ______
AND SIGN THE BOTTOM OF THIS FORM.

Please list any medical conditions that you believe the hosts of this activity may need to be aware of in case you are injured and you are unable to respond to questions.



Are you allergic to any medications such as:
0 Iodine;
0 Latex; or
0 Any medications.

___________________________

___________________________

___________________________

Other medical information you feel we should be aware of: _______________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

Emergency Contact
Name ________________________________________

Phone Number _________________________________

Signature ___________________________________


This Medical Information Form will be destroyed at the end of the semester/event.

_________________
Bodhi,
Final solution to all things needing final solutions.


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 Post subject:
PostPosted: Mon May 29, 2006 2:19 pm 
Barbarian
Barbarian

Joined: Sat Jun 25, 2005 10:26 am
Posts: 362
Location: Horse Grave(Dun Abhon, Louisville)
Do I need to fill this out and brig it with me, or can I fill one out when I get there?

_________________
Knight Of Wildwood- Sir Tenly OnFire.

Hoarde Win!!!!!!

M.C.Smurf Another Platinum Hit For Yeah Right Here.


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 Post subject:
PostPosted: Mon May 29, 2006 2:31 pm 
Mercenary
Mercenary

Joined: Sat Feb 28, 2004 10:40 am
Posts: 679
Location: Georgia
Realm: High Spires
Unit: Horde
If you are under 18 you need to fill it out prior to your arrival so that way you can get it notarized.

_________________
Bodhi,
Final solution to all things needing final solutions.


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