Initials
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I, the undersigned, understand and acknowledge that I will be participating in a full-contact sport hosted by Belegarth Medieval Combat Society (BMCS) and the Realm of Pyke the Ironport (herein referred to as “Pyke leadership”). I understand that participation in the events and practice sessions of Pyke includes possible strenuous physical encounters between myself and others that could lead to injury, permanent impairment, or even death.
Initials
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By signing this release form, I give my full consent to such contact and physical activities that may cause me harm or death. I hereby acknowledge that during the training I retain the right to step away from practice at any time I deem myself unsafe. I hereby also represent that I am physically and emotionally fit to engage in these combat activities. I also acknowledge that Pyke leadership is under no obligation to require me to prove my degree of health and fitness.
Initials
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I understand that neither BMCS nor Pyke leadership guarantee the fighting field to be free from debris or defects.
Initials
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If my conduct, actions, or statements while participating in any Pyke-related activities are determined to be inappropriate or detrimental to the safety or well-being of the other participants, I shall comply with the request of Pyke leaders, and/or any Belegrim acting as Marshals/Heralds (in the case of combat-related matters), to remove myself and my effects from the site immediately. I acknowledge that through my own actions I may be liable for injuries to persons and/or property.
Initials
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By signing this agreement, it is my stated intention to knowingly assume all risks involved in attending Pyke activities, and to absolve BMCS and Pyke leadership from any responsibilities or liability for any injury, physical or emotional, that I may sustain while participating.
Initials
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I fully understand and agree that Pyke leadership will not be held liable for any injuries, damages, or death caused by or resulting from negligence of leadership.
Initials
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While vaccination for COVID-19 and other illnesses is not currently required, Pyke leadership reserves the right to change this requirement in case of future pandemics. I will, however, exercise best judgement regarding the spread of illness – if I know that I am ill, I will be mindful of the community and the varying levels of immunity that people possess. I understand that participating in Pyke activities may expose me to a variety of illnesses, some potentially serious. I knowingly assume all such risks, both known and unknown, and assume full responsibility for my participation.
Initials
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I understand that the above statements are contractually binding and that Pyke leadership does not have the authority to modify the terms of this agreement once signed.
Initials
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I have fully read this waiver, and I understand and agree to everything stated above.
Printed Name
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First Name
Last Name
Date of Birth
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Month
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Day
Year
Fighting Name
Realm And/Or Unit
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
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Full Name
Fighting Name
Emergency Contact Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Today's Date
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Month
-
Day
Year
Applicant's Signature
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Signature of Parent/Legal Guardian (If applicant is under 18 years of age, the waiver must have the below signature, which must be notarized)
BMCS or Pyke Officer or Agent Initial
Initial
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