The Outremer Society

Adult’s Consent to Participate and Release Liability

(ONE consent form per person)

I, the undersigned, do hereby state that I wish to participate in activities sponsored by the organization known as The Outremer Society (hereafter referred to as “The Society”). The Society has rules, which may restrict the activities in which I can participate. These rules include, but are not limited to: the By-laws, the various chapter laws and the rules for combat related activities. The Society makes no representations or claims as to the condition or safety of the land, structures or surroundings, whether or not owned, leased, operated or maintained by The Society. I understand that all activities are VOLUNTARY and that I do not have to participate unless I choose to do so. I understand that these activities are potentially dangerous or harmful to my person or property, and that by participating I voluntarily accept and assume the risk of injury to myself or damage to my property. I understand that The Society does NOT provide any insurance coverage for my person or my property. I acknowledge that I am responsible for my safety and my own health care needs, and for the protection of my property.

In exchange for allowing me to participate in said activities and events of The Society, I agree to release from liability, agree to indemnify, and hold harmless, The Society and any agent, officer or employee of The Society acting within the scope of their duties, for any injury to my person or damage to my property. This Release shall be binding upon myself, successors in interest, and/or any person(s) suing on my behalf. I have read the statements in this document. I agree with its terms and without force, have voluntarily signed it.

I understand that this document is complete unto itself and that any oral promises or representation made to me concerning this document and/or its terms are not binding upon The Society, its officers, agents and/or employees.

I UNDERSTAND THAT THIS IS A LEGAL DOCUMENT. I HAVE READ AND UNDERSTOOD THIS RELEASE AND I UNDERSTAND ALL ITS TERMS. I EXECUTE IT VOLUNTARILY AND WTH FULL KNOWLEDGE OF ITS MEANING AND SIGNIFICANCE.

ALL areas below MUST be completed!

Legal name (PRINT): _________________________________________

Legal name (SIGN): _________________________________________ Date: ________________________

Witness (PRINT): _________________________________________

Witness (SIGN): _________________________________________ Date: ________________________