Belegarth MEDIEVAL RE-CREATION SOCIETY
ARNOR CHAPTER
located in St. Louis, Missouri

WAIVER AND RELEASE

In consideration of receiving permission from Belegarth Medieval Re-creation Society Arnor Chapter (hereon "Belegarth Arnor"), to participate as a member of the Belegarth Arnor and to participate in any activity, event, tournament, contest or meeting that Belegarth Arnor participates, sponsors, attends, or supervises, the Undersigned releases Belegarth Arnor, the owner of any premises where any Belegarth Arnor activity, event, tournament, contest or meeting occurs, and any other member of the Belegarth Arnor, individually, from any and all liability, claims, demands, actions, and causes of action, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the Undersigned, or any property of the Undersigned, while participating in any activity, event, tournament, contest or meeting that Belegarth Arnor participates, sponsors, attends or supervises.

The Undersigned being duly aware of the risks and hazards inherent upon participating in any activity, event, tournament, contest or meeting of the Belegarth Arnor, elects voluntarily to participate, knowing that participation requires physical contact by others to the person of the Undersigned and knowing that such participation may become hazardous and dangerous during the time that the Undersigned voluntarily assumes all risks of loss, damage, or injury, including death, that may be sustained by the Undersigned, or any property of the Undersigned while participating in any activity, event, tournament, contest, or meeting that the Belegarth Arnor participates, sponsors, attends or supervises.

This release shall be binding upon the distributees, heirs, next of kin, executors and administrators of the Undersigned.

In signing the foregoing release, the Undersigned acknowledges and represents:

(a) That he or she has read the above release, understands it, and signs voluntarily;

(b) That he or she is over 18 years of age and of sound mind;

(c) Undersigned represents that he or she has no physical or mental defects known to the Undersigned and unknown to the appropriate representative of the Belegarth Arnor that would endanger or harm the Undersigned while participating in any activity, event, tournament, contest or meeting that the Belegarth Arnor participates, sponsors, attends, or supervises.

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Undersigned (Sign name here)

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Undersigned (Print name here)

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Address

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City, State, and Zip

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Phone

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E-Mail

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Name of person to contact in emergency

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Emergency phone number