The Kingdom of Pentwyvern - Waiver

Real Name of Participant _____________________________________ Date of Birth _________________ Telephone @ (home)
_______________________ Address (Street, C, S, Zip) ____________________________________________________________________ E-mail_________________________________

Emergency Contact: Name___________________________________ Relationship to Participant _______________

Telephone #____________________ *****************************************************************************************************************************************************************************************

Character's Name ____________________________________________Realm __________________________________

Unit _________________________ ***************************************************************************************************************************************************************************************** If you have any serious health issues/problems and would like us to be aware of them, please list:

___________________________________________________

_________________________________________________________________________________________________________________________________ *****************************************************************************************************************************************************************************************

Description of Pentwyvern Medieval Fun & Battlegames: Pentwyvern Medieval Fun & Battlegames combines fast-faced full-contact combat simulation with elements of live action role-playing. Combat in group melees or between individuals is similar to the battle scenes in movies like Braveheart and Gladiator, with the biggest difference being that Pentwyvern Medieval Fun & Battlegames "weapons" are well-padded to prevent injuries. Pentwyvern Medieval Fun & Battlegames weapons are constructed to resemble Dark age/medieval swords, shields, spears, etc, and generally consist of soft foam layers bonded to a rigid core. Combatants may also become involved in grappling/wrestling. Pentwyvern Medieval Fun & Battlegames rules of combat are strictly enforced by the Heralds (referees) to ensure maximum safety along with maximum playability.

As with any outdoor, intense, contact sport, the possibility for injury exists. The types and likelihood of injury are similar to those in soccer, rugby, and lacrosse, and, as in those sports, severe injuries can occur.

WAIVER: In consideration of receiving permission from PENTWYVERN MEDIEVAL FUN & BATTLEGAMES (Pentwyvern) to participate in any Pentwyvern -sponsored activity, event, tournament, contest, or meeting, the undersigned assumes full responsibility for any bodily injury and/or property damage arising out of or related to my attendance and/or participation. I fully release Pentwyvern, its members, participants, observers, officers, officials, owners and/or administrators of land upon which the event/activity is being held, and/or anyone administering emergency medical assistance from liability to myself, my assigns, heirs, and next of kin for any injury to myself or damage to my property arising out of my attending/ participating a Pentwyvern event/activity. I hereby agree that if at any time I feel any Pentwyvern activity/event to be unsafe or if I observe unsafe behavior on the part of other participants/observers, I will immediately notify the appropriate Pentwyvern officials and/or refuse to participate in, or observe any further activities/events.

The undersigned is aware of the risks and hazards inherent in participant in any activity, event, tournament, contest or meeting of Pentwyvern and elects voluntarily to participate, knowing that participation involves significant physical contact by others to his person and that such participation my entail a risk of injury.

In signing this release, the undersigned acknowledges and represents: That he or she has read the above release, understands it, and signs voluntarily; That he or she is over 18 years of age and of sound mind; That, if the undersigned intends to participate in Pentwyvern activities, he or she has no known physical or mental defects that would increase the likelihood of serious injury from such participation; That, if the signing on behalf of a Minor participant, the undersigned has the legal capacity to do so.

__________________________________________________________ ____________________________________________________________ Undersigned (sign name here) Relationship to Minor

__________________________________________________________ ____________________________________________________________ Undersigned (print name here) Phone (if different from Minor)

__________________________________________________________ ____________________________________________________________ Address (if different from Minor) E-mail (if different from Minor)

__________________________________________________________ ____________________________________________________________ City, State, and Zip (if different from Minor) Date

State of: __________________

City of: ___________________

To Wit:
I HEREBY CERTIFY that on this day of , . Personally appeared and made oath in due form of law that the matters and facts set forth in the foregoing Agreement are true and correct as therein stated and that said Agreement is in fact his/her act and deed and that (s)he has full understanding thereof.

WITNESS my hand and Notarial Seal:

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NOTARY PUBLIC