COA Waiver

AIRSOFT WAR #14

RELEASE AND WAIVER OF LIABILITY AGREEMENT

I, (“Parent or Guardian or Adult”), acknowledge that I have voluntarily chosen to or allowed my minor son, or ward, to participate in the following activities:

Airsoft War centered at, but not limited to,

Stony Field, 200 NW 95th Street, Redmond, Oregon, 97756

March 2nd, 2013

I AM AWARE THAT THESE ACTIVITIES ARE INHERENTLY HAZARDOUS ACTIVITIES AND THAT MY SON OR WARD OR I COULD BE SERIOUSLY INJURED OR EVEN KILLED. I AM VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF THE DANGER INVOLVED, AND AGREE TO ASSUME ANY AND ALL RISKS AND RESPONSIBILITY OF BODILY INJURY, DEATH OR PROPERTY DAMAGE, WHETHER THOSE RISKS ARE KNOWN OR UNKNOWN.

I verify this statement by placing my initials here:________________

As consideration for being permitted by Mr. Matthew L. Jacobson to

participate in these activities and use his property and the surrounding properties wherever this activity may lead,

I forever release the Jacobsons and any volunteers or representatives (collectively “Releasees”) associated with the activities of this day, including all matters related to the present condition of the property, from any and all actions, claims, or demands that I, my assignees, heirs, guardians, next of kin, spouse and legal representatives may have in the future, for injury, death, or property damage, related to (i) my, my son’s or my ward’s participation in these activities, (ii) the negligence or other acts, whether directly connected to these activities or not, and however caused, by any Releasee, or other participant.

I HOLD HARMLESS AND INDENIFY THE PROPERTY OWNERS OF ANY RESPONSIBILITY FOR ANY AND ALL POTENTIAL HAZARDS ASSOCIATED WITH THIS ACTIVITY AND WITH THIS PROPERTY, INCLUDING SURROUNDING PROPERTIES WHERE THIS ACTIVITY MAY LEAD.

I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS

CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN ME AND MR. MATTHEW L. JACOBSON, AND SIGN IT OF MY OWN FREE WILL.

ADULT PARTICIPANT, OR PARENT, OR GUARDIAN

Signature:____________________________________________________

Address:_____________________________________________________

Date:__________