Please read the following if you plan on shooting at John Levique:
If you are planning to fire your weapons at John LeVique Pirate Days, 2010, we require that you take the safety class, and complete the attached ((below)) application. The application can be e-mailed to trollmactavern@yahoo.com
The West Coast Mutineers will be offering their black powder Gun Safety Course on Sunday, May 23rd.
The class will begin at 2pm following their cast rehearsal.Please bring your black powder weapons and cleaning kits for inspection by Quartermaster Troll.
If you are planning to attend this class, please contact Michele or Troll so they will have enough copies to hand out.
The address is :
Gulfport Recreation Center
5730 Shore Blvd. S.
Gulfport, FL 33707
If you have any questions, please feel free to contact them at 941-807-1255.
Thank you-
Michele Spears/Gary Alsup
West Coast Mutineers
P.S. All performers MUST attend the morning meetings at 9 am on Saturday 6/12 and Sunday 6/13 in order to receive their credentials for performing and/or Black Powder clearance.
**************************************************************************************************************
2010 BLACKPOWDER WEAPONS FIRING APPLICATION
Name: __________________________________
Address: ________________________________
Phone #'s: _______________________________
E-Mail: _________________________________
Pirate name: _____________________________
Crewe affiliation: _______________________________________
Weapons*-(all pistols, rifles and cannons) ________________________________________________________________________________________________________
Certification-(Manner of instruction, curriculum) __________________________________________________________________________________________________
Experience-(Yrs., Festivals you have fired weapons at) _____________________________________________________________________________________________
*All pistols and rifles must have a working half-dim bulb or other type of safety. Any weapon without one or the other will not be fired at this event.
Participants will not fire weapons while under the influence of alcohol or drugs.
Participants will only fire weapons at Festival sanctioned events, locations and times.
Participants will be firing weapons at their own risk.
By signing this document the participant absolves _______________________, of any liabilities caused by bodily injury or damage to personal items during this event.
Signature __________________________________ Date ________________
SIK Promotions
Rev.20100301
Waiver, Release and Hold Harmless Agreement
1. Enter the name of event: _________________________________________________
2. Date(s) of event: ________________________________________________________
I agree and acknowledge as follows:
3. Release of Liability. I, unconditionally waive, release, indemnify and forever discharge and hold
harmless, SIK Promotions, the city and or county the event is held in, all sponsoring organizations,
their directors, officers, employees, agents and volunteers, successors and assigns, and all other
persons directly or indirectly liable, from all claims of legal or financial liability of any kind,
including but not limited to, personal and economic injury, loss, costs, or damage arising out of or in
conjunction with the above named festival or event, whether foreseeable or unforeseeable, including
those resulting from negligence or fault, without regard to any hazards which may exist, whether
hidden or obvious.
4. Severability. If any part of this Waiver and Release is found to be invalid, all other parts of this
agreement shall remain binding and continue in full force and effect. I expressly agree that this
agreement shall be construed as broadly as permitted by the law of the State of Florida.
5. Acknowledgment of Voluntariness. I have not been pressured or coerced in any way to
participate in these activities. Any activities I undertake are done so voluntarily and solely for
purposes of participating in or attending the above festival or event.
6. Affirmation. I affirm that I am an adult and legally competent to sign this release; that the terms
of this release are contractual; and that this release shall be binding on me, my personal
representatives, heirs, successors and assigns.
I have fully read and understand the contents of this agreement and I further acknowledge that I
voluntarily execute the same without inducement or promise not contained herein.
Signature________________________________________________Date:__________________________
Full Name - Please Print______________________________________________________________________________________
Title______________________________________________________________________________________
BusinessName___________________________________________________________________________
Address________________________________________________________________________________
City, State, Zip___________________________________________________________________________
You may want to repost this in the JLD 2010 thread, here: http://www.renaissancefestival.com/forums/index.php?topic=11258.75
Thanks...Done