IMPORTANT: THIS IS A LEGAL DOCUMENT
Please read and understand this document before signing. If you have any questions please ask us or consult an attorney.
Navy Morale, Welfare and Recreation (MWR) Department, [U.S. NAVAL SUPPORT ACTIVITY, NAPLES, ITALY] and its staff have done everything possible to assure that our patrons have a rewarding Archery experience. We wish to inform our patrons that Archery is not risk free. The same elements that contribute to the unique character and fun of Archery, such as physical exertion or being in the outdoors can cause loss or damage to equipment, and injury, illness or in extreme cases, permanent trauma or death to yourself or others under your supervision. We do not want to heighten or reduce your enthusiasm for the experience, however, we want you to be aware in advance of what to expect, and be informed of some of the possible risks. We ask that you read and sign this release and waiver, then return it to our office.
ARCHERY ACKNOWLEDGMENT OF RISK

I, (Print Member Name) _______________________________ acknowledge and agree that the sport of Archery is an inherently dangerous activity and even under the best of circumstances the possibility and risk of me sustaining injury and/or causing injury to other cannot be eliminated. I further understand that:
1. There are significant risks and dangers involved when using bows and arrows, if used recklessly or incorrectly, which will cause serious injury.
2. The string on the bow may cause abrasions or burns to arms.
3. Arrows may hit objects other than the intended target.
4. If a person is hit with an arrow blindness, concussions and contusions are just some of the potential injuries.
5. These risks and activities in general can cause property damage, bodily and personal injuries, illness, dismemberment, paralysis and death to you or members of your family.

The list of possible accidents stated above may inflict bodily injury, disease, strains, fractures, dismemberment, partial and/or total paralysis and other ailments that could cause serious disability or death. It is also possible that some participants may suffer mental anguish or trauma as a result of their injuries.

This list is not an exclusive or exhaustive list of possible injuries, trauma, or accidents that may occur while participating in the archery program. Most of these injuries are rare and you are not likely to encounter them. However, they have occurred and you need to know about them and other possible injuries not mentioned above. These injuries occur more often when participants are using drugs or alcohol or not physically able to undertake the activity.
PRECAUTIONARY ARCHERY PRACTICES
I UNDERSTAND THAT WHEN PARTICIPATING IN ARCHERY I SHOULD TAKE THE FOLLOWING PRECAUTIONS:
1. Never shoot an arrow where you cannot see where it will land.
2. Never shoot an arrow straight up into the air or raise the point of the arrow
3. Never shoot a cracked, bent or damaged arrow.
4. Never point an arrow at a person and never shoot to the side of a person
5. Never pretend to shoot towards a person, people can die just as easily from heart trouble or injury when jumping out of the way of an anticipated arrow flight.
6. Never stand in the shooting lane forward of an archer about to shoot. Not only do you destroy his/her concentration, but also place yourself in danger from a mis-nocked or badly shot arrow which could fly in any direction.
7. While someone else is shooting, keep your eyes and mind alert for possible danger, while shooting. An archers concentration os solely on the target.
8. Where possible danger exists, DO NOT SHOOT.
9. If you have any doubts of any kind, DO NOT SHOOT.
10. Remember at all times that the bow and arrow can be and are deadly weapons.
11. When not on the shooting wait behind on the waiting /equipment line.
12. Do not load/draw a bow other than on the shooting line and facing the target.
13. Do not advance beyond the shooting line until told to do so.
14. Do not run or fool around at any time.
15. Take care when removing arrows from the target; do not approach the target directly from behind and make sure no one is behind you when pulling out the arrows.
16. Do not stand directly behind the arrows to be pulled, the nock could jab you in the face or eye, causing serious injury.

TRANSPORTATION ACKNOWLEDGMENT OF RISK
As part of the Archery program, Navy MWR Department [U.S. NAVAL SUPPORT ACTIVITY, NAPLES, ITALY], may provide transportation by motor vehicle, van, or bus to and from the starting and ending point.  In that event, I understand and agree that I cannot hold [U.S. NAVAL SUPPORT ACTIVITY, NAPLES, ITALY] liable for any injury I received due to the transportation Navy MWR Department U.S. NAVAL SUPPORT ACTIVITY, NAPLES, ITALY [] provides.  I agree that the terms of this release shall cover any injury I receive due to an accident on the part of Navy MWR Department []U.S. NAVAL SUPPORT ACTIVITY, NAPLES, ITALY whether by their negligence or the negligence of others.

CONTRACT, WAIVER, RELEASE AND INDEMNIFICATION
I certify that my family, including minor children and myself are fully capable of participating. I state that I have read the above statement on some of the possible risks associated with Archery. Therefore, I assume full responsibility for myself, my family, including minor children, for bodily injury, death and loss of personal property and any expenses as a result of my negligence, negligence of my family, negligence of another participant in the Archery program, or the negligence of Navy MWR [U.S. NAVAL SUPPORT ACTIVITY, NAPLES, ITALY] and its staff. I also understand that Navy MWR Department [U.S. NAVAL SUPPORT ACTIVITY, NAPLES, ITALY] reserves the right to refuse any person it judges to be incapable of meeting the rigors and requirements of participating in Archery.  My family and I are in good physical condition and able to undertake Archery.
I agree to indemnify and hold harmless Navy MWR, Navy MWR DepartmentU.S. NAVAL SUPPORT ACTIVITY, NAPLES, ITALY], U.S. NAVAL SUPPORT ACTIVITY, NAPLES, ITALY [] and its staff, and the U.S. Navy and its members, agents and employees from all claims, damages, losses, injuries and expenses arising out of or resulting from participation in these activities. I further agree to release, acquit and covenant not to sue Navy MWR, Navy MWR Department []U.S. NAVAL SUPPORT ACTIVITY, NAPLES, ITALY, [U.S. NAVAL SUPPORT ACTIVITY, NAPLES, ITALY] and its staff, and the U.S. Navy and its members, agents and employees for any/ all actions 

___________________
												Patron’s initials
or claims arising out of participation in the Archery program. In short, I cannot sue Navy MWR, Navy MWR [COMMAND] 
[COMMAND] and its staff, and the U.S. Navy and its members, agents and employees, and if I do, I cannot collect any money.
I agree that the site of any lawsuit, and the law governing any such lawsuit, shall be governed under the Federal Tort Claims Act, Military Claims Act, Foreign Claims Act, Suits in Admiralty Act, Public Vessels Act or Admiralty Extension Act, which ever is applicable.  The terms of this agreement shall continue and be in effect after the Archery trip/program or activity has ended.
I hereby agree that if the U.S. Navy, Navy MWR or [COMMAND] is forced to defend any action, lawsuit or litigation by myself, my executors, or my heirs, on my family's or my behalf, my heirs or executors and I agree to pay court costs and attorney fees if they successfully defend such action, lawsuit or litigation. 
Should a court of competent jurisdiction declare any paragraph or part of this agreement unenforceable, the remaining parts or paragraphs shall remain in full force and effect. A copy of this release can be used as if it was an original.

CONSENT TO PUBLICATION OF PHOTOGRAPH
I authorize and release to Navy MWR Department [COMMAND] and its staff the use of my image in any photograph or video recording for any purpose of Navy MWR, and the Navy MWR Department [COMMAND].

MEDICAL TREATMENT CONSENT
I hereby give permission for transportation to any medical facility or hospital and I authorize any qualified guide, or medical personnel to render necessary emergency medical care for my family or me.  I hereby authorize the release of any medical information, including information concerning my HIV or “AIDS” status, in the possession of Navy MWR Department [COMMAND] to any medical facility, hospital, ambulance, first aid provider, first aid service, doctor, nurse or other such person rendering care on my behalf.  I hereby waive any action or claim against Navy MWR Department [COMMAND] and its staff or any health care provider, hospital, doctor, nurse or first aid provider for the release of this medical information including my HIV or “AIDS” status.
I have adequate health, disability and life insurance for my family and myself.
I, _________________________________________________, of my own free will, for my family, my minor children, my heirs and executors and myself, have read, understand and acknowledge the risks and liability for myself, and my family this _______ day of ___________________________ (month/year).
[__]	By checking this box, I indicate that my family and I have previous ________________ experience.
[__]	No one in my family or I have any medical condition that would prevent our participation in this activity except: ___________________________________________.
I have read and understood this agreement.
			
FIRST PARTICIPANT SIGNATURE		SECOND PARTICIPANT SIGNATURE
			
PRINTED NAME		PRINTED NAME
			
ADDRESS		 THIRD PARTICIPANT SIGNATURE
                                                                                                                  __________________________________________
                                                                                                                    PRINTED NAME
			
PARENT(S) SIGNATURE OF MINOR PARTICIPANT		PARENT(S) SIGNATURE OF MINOR PARTICIPANT

PHONE: [_____] ________________			
IN CASE OF EMERGENCY PLEASE CONTACT: _______________________________________________
PHONE: __________________________________________________________________________________
I CARRY MEDICAL INSURANCE. YES _________ NO _________ GROUP NUMBER: _______________
NAME OF PROVIDER: ____________________________________________________________________