CONSENT TO PARTICIPATE AND RELEASE LIABILITY 

Player's Name____________________________________________               

Player’s Full Date of Birth           -       -            .                        

Address________________________________________________           ______________________________________________________

Telephone______________________    Emergency Contact______________________

E-Mail (Optional. Only enter if you would like to join the mailing list):_________________________________ 

All players must be at least 14 years of age. All players under 18 years of age must have the signed permission of their parent or guardian to participate. All players under 16 years of age must be accompanied by a chaperone of at least 18 years of age appointed by their parent or legal guardian.            

	I, the undersigned, do hereby state that I wish to participate in activities sponsored by the Shogun Council (hereafter “SC”). SC has rules which govern and may restrict the activities in which I can participate.  Some physical conditions including pregnancies will preclude or restrict the activities in which I can participate and SC has the sole discretion in deciding who can or cannot participate.

	SC 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 SC.

	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 SC does not provide any insurance coverage for my person or 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 these SC activities and events, I agree to release from liability, agree to indemnify, and hold harmless SC, and any SC agent acting within the scope of their duties or the owners of the property on which Shogun activities are held, 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 the terms and have voluntarily signed it.  I understand that this document is complete unto itself and that any oral promises or representations made to me concerning this document and/or its terms are not binding upon SC, 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 WITH FULL KNOWLEDGE OF ITS MEANING AND SIGNIFICANCE.  

Signature of Player:                                                                                                          	Date_______________

Sign. of Parent/Guardian:                                                                                                 	Date______________
(If under 18)

Name of Authorized Chaperone (Please Print):__________________________________________________ 
(If under 16)