dodge ball players wavier

WAIVER

I_________________________________(please print name) acknowledge and accept that there is inherent risk in playing the game of dodge ball and by engaging in this activity I consent that I am qualified, in good health, and proper physical condition to participate.  If at anytime during play I feel that the conditions are in anyway unsafe, dangerous, or put my personal safety beyond the assumed risk, I will discontinue further participation.

By signing this waiver, I,_____________________________, hereby assume all responsibility for any public, private, or personal damage including but not limited to property damage to the facility, it's equipment and surrounding areas and personal damage or injury to another participant up to and including death.  I understand that the activities in which I will participate are inherently dangerous and could cause serious and or grievous injury.

I accept full responsibility for my actions and under no circumstance hold Oregon Alternative Sports, Inc. and Portland Dodge Ball responsible for any damage or injury incurred during my participation before, during or after playing dodge ball.  My signature is proof that I am of a competent state of mind to enter into this waiver and agree to waive and release Oregon Alternative Sports, Inc. from any liability to the full extent of the law.  This waiver may not be amended.  If I am under the age of 18 a parent or guardian's signature is required.

Date_____________________________

Printed name of participant ______________________________________________

Signature of Participant

I am under the age of 18 and below is a signature of a parent or guardian allowing me to play.

___________________________________________________________date_________

Print name of parent or guardian _________________________________________