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Nevada Civil War Volunteers
Enlistment Record
200
8

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Please PRINT this form and clearly enter the requested information

Adult #1 Name:   DOB: 
Adult #2 Name:   DOB: 
Minor #1 Name:   DOB:
Minor #2 Name:   DOB:
Minor #3 Name:   DOB:
Address:  City:  State/ZIP: 
Phone:  E-mail:  Receive The Sentinel via    Mail     Webpage

I, the undersigned, agree to abide by the Bylaws and Safety Standards governing the Nevada Civil War Volunteers Incorporated, and release them of any and all obligations.

Know all men by these presents, that I do hereby, for all heirs, executors, administrators and assigns, fully and forever, with the full knowledge that there is a possibility of injuries to my or my child's anatomy, release and discharge the NEVADA CIVIL WAR VOLUNTEERS, INC. (all or part), of and from all claims, demands, damages, rights of action and causes of action, on account of either known or unknown, concealed or hidden, external or internal, personal, physical, mental or nervous injuries or disease, or damage to any portion of my or my child's anatomy, or damage to personal property of whatsoever description resulting, or which could or may result from an accident or anything which occurred.

I do further release said NEVADA CIVIL WAR VOLUNTEERS, INC. (all or part), from all suits, debts, dues, covenants, controversies, agreements, promises, variances, trespasses, judgments, executions, claims, and demands whatsoever in law or in equity. 

I also understand and agree that this full and final release is intended to cover and does cover all and any future injuries not known to either party hereto, or which may later develop, or be discovered, including the effects or consequences thereof and including all causes of action thereby. 

I further understand that this is a compromise settlement without any admission of liability on the part of the NEVADA CIVIL WAR VOLUNTEERS, INC. (all or part), and, in executing this release, that participation in the NEVADA CIVIL WAR VOLUNTEERS, INC. activities includes, but is not limited to the re-enactment of battle scenes between opposing forces under situations closely approximating actual battles utilizing black powder, small arms, cannon and swords.  Consent is hereby given to whatever medical care might be available and or provided for injury occurring during the above activities when authorized or contracted for by any officer of the NEVADA CIVIL WAR VOLUNTEERS, INC

I hereby state that I am a declarant in the foregoing declaration; or, that I am the parent or legal guardian of a minor child whose name appears above and am empowered to execute this release.  I also state that I have read the same, understand the contents thereof, and agree to the contents thereof.

Adult #1 Signature: Date:
Adult #2 Signature: Date:
Please send Personal Check or Money Order with this application to:
Nevada Civil War Volunteers, Incorporated
P.O. Box 11033
Reno, NV 89510
STAFF USE ONLY:
Dues Paid:  $_________________  
Date Received:  ______________
Received by:  ____________________________________________