Belegarth MEDIEVAL RE-CREATION SOCIETY
ARNOR CHAPTER
located in Maryland Heights, Missouri

PARENT'S WAIVER AND RELEASE

In consideration of receiving permission from Belegarth Medieval Re-Creation Society, Arnor Chapter (herein "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 University of Illinois Urbana-Champaign, 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's minor child, or any property of the Undersigned or the Undersignedis minor child, 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 allow Undersigned's minor child to participate, knowing 'that participation requires physical contact by others to the person of the Undersigned's minor child 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's minor child, or any property of the Undersigned or Undersigned's minor child 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 and Undersigned's minor child.

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 on behalf of themselves and their minor child;

(b) That he or she is over 18 years of age and of sound mind and is the parent or legal guardian of the minor child named below;

(c) Undersigned represents that Undersigned,' s minor child 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's minor child while participating in any activity, event, tournament, contest or meeting that the Belegarth Arnor participates, sponsors, attends, or supervises.

__________________________________________ Undersigned (Sign name here) __________________________________________ Undersigned (Print name here) __________________________________________ Name of minor child (Print) __________________________________________ Address __________________________________________ City, State, and Zip

__________________________________________ Phone __________________________________________ E-Mail __________________________________________ Name of person to contact in emergency __________________________________________ Emergency phone number