Z-Rock Waiver       

 

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TIMES

FRIDAY   -     TEAM PRACTICE
 
     SATURDAY   -  OPEN PLAY,  12:00-6:00
 
SUNDAY -
1:00 - 5:00
 
WEEK DAYS - SCHEDULE IN ADVANCE
 
 
Field Paint Only

Participants Affidavit and Release

This AFFIDAVIT AND RELEASE is executed on the date set forth under the signature below, by _________________________________________, a resident of , and participant in of the __________________________ Contest (the "Event"), in favor of _________ (the "Station") whose address is _______________________________________________, and Cumulus Broadcasting LLC, address is 3280 Peachtree Rd NW, Suite 2300, Atlanta, GA 30305, each a sponsor of the Event.

I, , being duly sworn, depose, and say the following:

I am submitting this Affidavit and Release to the Station and Cumulus Broadcasting LLC with the understanding that it will be relied upon to determine whether I am entitled to receive [insert description of prize as outlined in your rules] (the "Prize") for which I have been selected to win in the Event sponsored by the Station and Cumulus Broadcasting LLC. I HAVE READ THIS RELEASE AND FULLY UNDERSTAND ALL OF ITS TERMS.

I am of full legal age, my Social Security Number is _____--____--______, and I currently reside at .

I am not, nor is any member of my immediate family (spouse, mother, father, sister, brother, daughter or son, regardless of where they live) or members of my household (whether related or not), an employee, agent, subsidiary, or affiliate of the Station Cumulus Broadcasting LLC or participating sponsors.

I hereby certify and affirm that I entered the Event in accordance with the Official Promotional Rules attached hereto as Exhibit A and I have read and understand the Official Promotional Rules.

I understand and acknowledge that all federal, state, local, and any other applicable taxes that may become or are due in connection with my participation in the Event and my receipt of the Prize are my sole responsibility and that the Station will report my winnings, if any, to the Internal Revenue Service in accordance with the law.

I hereby give the Station and Cumulus Broadcasting LLC, and their licensees, affiliates, representatives, agents and assigns the irrevocable and unrestricted right to copyright, in its own name or otherwise, and use, re-use broadcast and publish or re-publish my name, city of residence, any photo, video tape, film or any other likeness, including portraits and pictures of me, in whole or in part, as part of a composite, retouched or distorted in character or form and without restrictions as to any changes, transformations or alterations, and including my voice, recorded or live, for any reason and in any way the station deems necessary without compensation, unless prohibited by law. I hereby waive any right I have to inspect or approve the finished product or products and the use to which it mat be applied. I hereby release, discharge, and agree to save harmless the Station and Cumulus Broadcasting LLC and its affiliates, representatives and agents from any and all claims I may have against the Station and Cumulus Broadcasting LLC in connection with the taking, production or the use of my name, city of residence, any photo, video tape, film or any other likeness, including portraits and pictures of me, in whole or in part, as part of a composite, retouched or distorted in character or form and without restrictions as to any changes, transformations or alterations, and including my voice, recorded or live. I further acknowledge that the Station or Cumulus Broadcasting LLC owns or will own exclusively any photographs or pictures of me used for such purposes, including the copyrights in them, regardless of the form in which they have been or may be produced and used, and I hereby assign all such ownership rights to Cumulus Broadcasting LLC.

I, on my own behalf and on behalf of my heirs and assigns, do hereby now and forever fully and finally release, remise, acquit and discharge Cumulus and its subsidiaries, affiliates, shareholders, directors, officers and employees, and their respective representatives and agents, of and from any and all rights, claims, debts, damages, demands, actions, liabilities, responsibilities, causes of action, covenants, suits and judgments, of any kind or nature whatsoever, whether known or unknown, developed or undeveloped, anticipated or unanticipated, discoverable or undiscoverable, which I have or may have or may claim to have against Cumulus, arising out of or in any way related to or associated in any way with the participation in the Event, winning or losing the Prize or by use or non-use of the Prize received. Further, I understand that any photographer or artist hired by Cumulus to take my picture in connection with the Event is an independent contractor of Cumulus and has no authority to act on behalf of the Company. Accordingly, I hereby release, discharge and agree to hold harmless Cumulus, its affiliates, representatives and agents from any liability arising from the actions or inactions of such photographer or any assistants, agents or representatives of same.

I represent, warrant, covenant and agree that I am undertaking participation in the Event and the Prize entirely of my own choice and volition, and that it has not been requested, suggested or required in any way by Cumulus that I undertake participation in the Event and the Prize. I acknowledge and recognize that my activities in connection with the Event and the Prize involve potential danger to my person and property and the property of others, including Cumulus, and I knowingly and voluntarily intend to participate in the Event and the Prize.

I agree to return to the Station or Cumulus Broadcasting LLC any prize that may be awarded to me if any statement made by me in this Affidavit and Release is false.

IN WITNESS WHEREOF, I have executed this Affidavit and Release as of the date provided below.

Sworn to and subscribed

before me this ____ day

of , 20 .

(Signature)

 

 

Notary Public (Name)

[NOTARIAL SEAL]

(Date)

 

 

 

 

 

Agreement and Consent of Parent or Guardian of Minor

I, as parent or guardian of the above participant of the [Insert name of contest] Contest, represent to [insert station call letters] and Cumulus Broadcasting LLC that the statements made above concerning my child or ward are true. I hereby give my permission for my child or ward to participate in the [Insert name of event] and to accept any prize that may be awarded, and further, in consideration of the agreement of [insert station call letters] and Cumulus Broadcasting LLC to award any prizes, agree individually and on behalf of my child or ward to the terms of the above agreement and release of liability. I further acknowledge that my child or ward may or may not receive any prize.

Sworn to and subscribed

before me this ____ day

of , 20 .

(Signature)

 

 

Notary Public (Name)

[NOTARIAL SEAL]

(Date)

 

 

 

FULL RENTAL                 $30.00            FIELD FEE, MARKER, BARREL BAG, HOPPER, 9oz, MASK, 200 PAINTBALLS, ALL DAY AIR

FIELD FEE                         $5.00             FIELD FEE

ALL DAY AIR                   $10.00           HPA or Co2

MARKER RENTAL          $10.00           MARKER ONLY

MASK RENTAL                $5.00             MASK ONLY

 

                                                                                    ASK ABOUT UPGRADES

Co2 PRICES            HPA PRICES                       PAINTBALL PRICES

9oz        $3.00           47/3000    $2.00                   100                $5.00                         FIELD PAINT ONLY
12oz      $4.00           68/3000    $3.00                   500                $20.00
16oz      $5.00           45/4500    $3.00                   1000              $30.00
20oz      $6.00           68/4500    $4.00                   2000              $50.00                GROUP DISCOUNTS AND 

                                                                                                                                       BULK RATES AVAILABLE

Telephone: 502-229-2952               E-mail: jdeere160@hotmail.com         Contact Us: Click Here

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Last modified: May 26, 2008