Official Tournament Entry Form
OFFICIAL ENTRY FORM
Membership Number ______________________________________________
Tournament Date __________________________________________________
Name ___________________________________________________________
Address _________________________________________________________
City _____________________________State _________Zip____________
Phone _____________________________________Age _____________
Enclosed is:
[ ] $5.00 Entry Fee
[ ] I will pay my Entry Fee at the check in table
[ ] I am not currently a member of The Crappieteers Fishing Club and I would like to join for FREE today. My application information is the same as above.
PARTICIPANT RELEASE OF LIABILITY
READ BEFORE SIGNING
In consideration of being allowed to participate in any way in The Crappieteers Fishing Club Tournament program,related events and activities of the fishing tournament I,_____________________________________
the undersigned, acknowledge, appreciate, and agree that:
1. The risk and injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal disipline may reduce this risk, the risk of serious injury does exist; and,
2. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others, and assume full responsibility for my participation;and
3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately;and;
4. I, for myself, and on behalf of my heirs,assigns, personal representitives and next of kin, hereby release, indemnify, and hold harmless The Crappieteers Fishing Club, it's officers, officials, agents,and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessers of premises used to conduct the event("releasees"), with respect to any and all injury, disability death, or loss damage to person or property, whether arising from the negligence of the releasees or otherwise, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT AND THE ATTACHED RULES, FULLY UNDERSTAND THEIR TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
_________________________________________
PARTICIPANTS SIGNATURE
AGE:____________DATE SIGNED:_________________________
FOR PARENTS/GAURDIANS OF PARTICIPANTS OF MINORITY AGE
(UNDER AGE 18 AT TIME OF REGISTRATION)
This is to certify that I, as parent/gaurdian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the releasees,and,for myself,my heirs, assigns, and next of kin, I release and agree to indemnify and hole harmless the releasees from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above, even if arising from the negligence of the releasees, to the fullest extent permitted by law.
X_________________________________________
PARENT/GAURDIAN'S SIGNATURE
EMERGENCY PHONE NUMBER(S)
__________________________________________
or________________________________________
Date signed________________________________
Email: tcfcmissorui@aol.com
