|
Amtgard,
The Kingdom of the Wetlands
|
General Waiver and Informed Consent to Participate
in all Amtgard Event & Functions
|
|
|
Please print all information and turn in to the Prime Minister,
Chancellor or Seneschal
before you participate in your first event.
Mundane (real) Name
Persona Name
Address
City State
Zip-
Farspeaker (Phone) Number ()
Your date of birth
I agree to release and hold harmless Amtgard-The Kingdom of the Wetlands,
Amtgard splinter group chapters, and all members of all Amtgard Chapters
from and against all claims, demands, and actions in respect to damage
to my person or my property arising in
connection with my participation in Amtgard functions. Furthermore, I
accept and understand that neither
Amtgard nor any Amtgard members are responsible for any injuries received or
given at any Amtgard function. I
further understand that, as with any physical sport, participation in
Amtgard has an element of risk.
I also authorize by my signature
herein permission for medical treatment by professional means, if necessary,
and I am unable to answer for
myself.
Note: Anyone under the age of 14 must have a parent or guardian present
whenever they are participating in one of the fighting activities, and may
only participate in fighting activities
with the permission of the Monarch or Guildmaster of Reeves.
| Waiver must be signed in person |
MM/DD/YYYY |
| Signature
of
Participant |
Date |
|
|
|
Must be signed in person
|
|
|
Signature of Parent or Guardian (If Participant is under 18 years
old) |
Emergency Contacts (List two)
Name:
Phone: (H)(W)
Name:
Phone: (H)(W)
|