BSC Agreement, Release & Waiver of Liability

BARBERTOWN SPORTSMEN’S CLUB, INC.

222 Kingwood Station Barbertown Road,

Frenchtown, NJ 08825

ESTABLISHED 1947

Barbertown Sportsmen’s Club, Inc. - Agreement, Release & Waiver of Liability 

(1)   I ACKNOWLEDGE, UNDERSTAND, DECLARE AND AGREE THAT:

(a) To the best of my knowledge, I am in good physical condition and have no disease or

injury that would be aggravated by participating in activities/events, WHICH MAY

INCLUDE BUT ARE NOT LIMITED TO PRACTICING ARCHERY, FIREARM USE, AND CAMPING, being attended.

(b) Participating or assisting others in participating in attended activities may involve

RISK OF INJURY TO ME, INCLUDING DEATH, LOSS OR DAMAGE TO ME OR MY PROPERTY,

or other consequences, which might result from my own actions, inaction or negligence

but also the actions, inaction or negligence of others, the rules of play, or the conditions

of the premises or of any equipment used;

(c) There may be OTHER RISKS not known or not reasonably foreseeable; and

understanding all of the above.

(2) I assume all of the above risks and release, waive, discharge, hold harmless,

indemnify and covenant not to sue Barbertown Sportsmen’s Club, Inc., its officers,

directors, agents, representatives, volunteers, coaches, trainers or any other individuals associated with Barbertown Sportsmen’s Club, Inc. I also release, waive, discharge, hold harmless and covenant not to sue the owners, lessors and lessees of the premises used to conduct the activities from ANY AND ALL LIABILITY FOR INJURY, INCLUDING

DEATH, LOSS OR DAMAGE TO PERSON OR PROPERTY, OR ANY OTHER CONSEQUENCE arising out of participation in, performance in or lack of performance

 in the activities.

(a) I assume the responsibility and the condition of my own equipment and or injury to

others participating in activities attended at Barbertown Sportsmen’s Club, Inc.

(3) I FURTHER AGREE THAT:

(a) Prior to participating in activities, I, or in the case of a minor, a parent or guardian,

will INSPECT the facilities and equipment to be used, and if I believe same to be unsafe,

I will immediately REPORT such condition(s) to the supervisor or officer(s) and either

DECLINE TO PARTICIPATE or ASSUME THE RISK of participating:

(b) I will ALLOW my PHOTOGRAPH, PICTURE or LIKENESS and/or VOICE to

APPEAR  in any documentary, promotional (including any and all advertisements),

television, radio, or film coverage of Barbertown Sportsmen’s Club, Inc. WITHOUT COMPENSATION.

(4) I CONSENT TO ALL EMERGENCY MEDICAL TREATMENT as may be deemed

appropriate under existing circumstances by medical personnel or personnel associated

with Barbertown Sportsmen’s Club, Inc.

 

I HAVE READ THIS FORM IN ITS ENTIRETY AND HAVE PROVIDED TRUTHFUL INFORMATION.

  

                                                                                                        

PARTICIPANT NAME (PRINT) (IF 18 OR OLDER)             PARTICIPANT SIGNATURE                                                   DATE: ____________  

 

Signature of Parent/Legal Guardian, individually and in the capacity as Parent/ Legal

Guardian is required if the Participant is under 18 years of age.

 

 

                                                                                                                                                                           

PARENT/LEGAL GUARDIAN NAME (Print)               PARENT/LEGAL GUARDIAN SIGNATURE      

                      DATE:                           

                         

                                                                                                                                                                          

ADDRESS                                           CITY                             STATE                                   ZIP CODE

                                                                                                                                                                          

           PRIMARY PHONE                                                                                 E-MAIL ADDRESS

 

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