PAINTBALL BONANZA OF HOUSTON
Insurance Program Provider - www.cossioinsurance.com
Paintball Bonanza of Houston = PBH    Phone (713-935-0552
Valid date from December 14, 2009 - December 14, 2010

READ CAREFULLY AND PLEASE PRINT CLEARLY AND LEGIBLE
WAIVER AND RELEASE OF LIABILITY

        In consideration of PBH furnishing services and/or equipment to enable me to participate in paintball games, I agree as follows.
        I fully understand and acknowledge that; (a) risks and dangers exist in my use of Paintball equipment and participation in Paintball activities; (b) my participation in such activities and/or use of such equipment my result in my injury or illness including but not limited to bodily injury, disease, strains, fractures, partial and/or total paralysis, eye injury, blindness, heat stroke, heart attack, death or other ailments that could cause serious disability; (c) these risks and dangers may be caused by the negligence of owners, employees, officers or agents of PBH; the negligence of the participants, the negligence of others, accidents, breaches of contract, the forces of nature or other causes. These risks and dangers may be from foreseeable or unforeseeable causes; and (d) by my participation in these activities and/or use of equipment. I hereby assume all risks and dangers and all responsibility for any losses and/or damages, whether caused in whole or in part by the negligence or other conduct of the owners, agents, officers, employees of PBH, or by any other person.
        I, on behalf of myself, my personal representatives and my heirs, hereby voluntarily agree to release, waive, discharge, hold harmless. defend and indemnify PBH and it's owners, agents, officers and employees from any and all claims, actions or losses for bodily injury, property damage, wrongful death, loss of services or otherwise which may arise out of my use of Paintball equipment or my participation in Paintball activities. I specifically understand that I am releasing, discharging and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by the owners, agents, officers or employees of PBH. This waiver and release good through December 14, 2010.

I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT AGREE IT IS MY INTENTION TO EXEMPT AND RELIEVE  PBH  FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE.

ALL PLAYERS OR SPECTATORS AT PAINTBALL BONANZA MUST COMPLETE A SAFETY ORIENTATION BEFORE PARTICIPATING AND/OR ENTERING PLAYING FIELD AREAS. IF  I CANNOT FOLLOW THE FIELD RULES, I WILL NOT BE ALLOWED TO PARTICIPATE THE REMAINDER OF THE DAY OR ALLOWED IN PLAYING FIELD AREAS.
                    OUR FACILITY IS FIELD PAINT ONLY!    ALL SERVICES AND PURCHASES ARE C.O.D.

Date Signed _______________        PLEASE PRINT CLEARLY AND COMPLETE EACH LINE AS REQUIRED

________________________________        __________        ______________       _______________
Player/Participant    Printed Name                             Age                    Date of Birth                        Phone #

________________________________        __________________________________________________________
Player/Participant    Signature                                Address                                                        City            State              Zip

MEDICAL PERMISSION AUTHORIZATION
Minimum Age Requirement 10 years old to participate in Paintball activities at Paintball Bonanza of Houston

If the participant is of minority age, the undersigned parent or guardian hereby gives the permission for PBH to authorize emergency medical treatment as may be deemed necessary for the child names above while participating in Paintball games from this date through December 14, 2010.

________________________________        _________________________        ______________
Parent or Guardian Signature                                    e-mail address                                     Emergency Phone