Battlefield Live SA (Pty) Limited Wynberg Laser Tag It looks like your internet is very good, do you want to synchronize the data? Total Signed: Total Returning: Sync data Thank you for completing our waiver form. Your submission for Wynberg Laser Tag event was processed successfully. Hi - welcome! Please let us know if you are a new customer, or a returning customer.... Make a selection New customer Returning customer (please use same email address). Name * Surname * email * Are you a new customer? I'm a new customer Are you completing this on behalf of a minor? Make a selection No Yes For legal Guardian (All fields compulsory) Guardian Full Name and Surname * Relationship to minor * Guardians valid Email Address * Guardians contact number (also for emergencies) * Minor 1 Remove Minor's name * Minor's Surname * Minor's date of birth * Day1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 MonthJanuary February March April May June July August September October November December Year2025 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Minor's gender * Make a selection Male Female Minor's age * Make a selection 123456789101112131415161718 Any medical conditions * Make a selection Yes No INSERT DETAILS HERE Add another minor First name First name * Last name Last name * Email Email * Contact Number Contact Number * Adult participants ID number Adult participants ID number Date of your event / party Date of your event / party * Day1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 MonthJanuary February March April May June July August September October November December Year2025 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Time of your event / party (00:00) Time of your event / party (00:00) * Gender Gender * Make a selection Male Female Gender diverse Any medical conditions we need to be aware of? Any medical conditions we need to be aware of? * Make a selection Yes No Emergency contact person Emergency contact person * Emergency contact number Emergency contact number * How did you hear about us? How did you hear about us? * Make a selection Brochure Word of mouth/referral Printed advertisement Internet search Social media Newsletter Radio or television Saw the facility Other By completing and submitting this form you are agreeing to the following: MINORS INDEMNITY ACCEPTANCE FORM INDEMNITY TO BE SIGNED BY THE PARENT OR LEGAL GUARDIAN OF CHILDREN UNDER 18 YEARS OLD PARTICIPATING IN BATTLEFIELD LIVE I, the undersigned acknowledge that I have read or have been made aware of the safety rules pertaining to the participation by my child in Battlefield Live, and that I understand these rules and accept the risks which are inherent in the participation in the aforementioned game. I am aware and understand that participation in the game involves intensive physical and mental exertion. I warrant that my child is free from any medical condition that may endanger his/her life or well being or the life or well being of any other participant. By my signature hereto, I undertake not to hold Battlefield Live liable for any injury, loss or damage which I or my child might sustain whilst participating in the game whether on the range or not and howsoever arising irrespective of whether such loss, injury or damage can be attributed to any act or omission of an employee of Battlefield Live. I understand that no child under the age of 7 years old may participate in a Battlefield Live SA event and that I will be truthful when disclosing my child’s age. I understand that no child may participate in a Battlefield Live SA event barefoot or wearing flip flops/crocs. I understand that no child may participate in a Battlefield Live SA event who has a pre-existing medical condition ie. Broken bones in a cast/split/sling, due to the nature of the activity. On behalf of my child; I RELEASE, DISCHARGE, WAIVE AND FOREVER HOLD HARMLESS, BATTLEFIELD LIVE SA FROM ALL CLAIMS FOR ANY LOSS HOWSOEVER SUSTAINED OR CAUSED. I warrant that I am over 18 years old and legally entitled to sign on behalf of my child and I indemnify Battlefield Live, it’s owner, it’s assigns, it’s staff, the range master and land owner from any and all claims, notions, suits, procedures, costs, expenses, damages and liabilities, including lawyers fees arising out of, connected with, or resulting from my playing the Battlefield Live game, and my use of the equipment, including without limitation the manufacture, selection, delivery, possession, use and operation of the equipment for its intended use or otherwise not intended use, and further indemnify Battlefield Live and the aforementioned parties against any claims for any loss, injury, damage or death sustained. I undertake to always play the Battlefield Live Game safely and in accordance with the safety rules and suggestions presented to me. I understand and accept that intense physical and mental exertion may occur during the course of the game and therefore I further warrant that I have no medical or mental condition or complaints that in any way may endanger myself or other players during or after participation in the game. I agree to these terms and conditions
