They can swim, but they can't hide

NATA APPLICATION

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North Alabama Tournament Anglers

Application to join

Name:___________________________________

Address__________________________________

__________________________________

Phone______________________

Cell________________________

Work_______________________

Email (s)__________________________________

FLW #____________________________________

 

Signature:_________________________________

Date_____________________________________


Official use only

Amount Paid________________________________

Collected by_________________________________           Date_______________________

 

 

 

 

NATA ANGLER PROFILES:

 

MEMBER SINCE:__________________

 

BOAT:___________________________

 

MOTOR:_________________________

 

ACCOLADES:_______________________

FAVORITE LAKE:_____________________

 

FAVORITE TECHNIQUE:________________

 

 

 

 

 

 

 

 

 

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PARTICIPANT RELEASE OF LIABILITY

NORTH ALABAMA TOURNAMENT ANGLERS BASS FISHING CLUB

PARTICIPANT NAME: (Please Print)

_______________________________________________________

In consideration of being allowed to participate in any way in the program, related events and activities, I the undersigned, acknowledge, appreciate, and agree that:

1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death.

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.

3. I willingly agree to comply with terms and conditions for participation. If 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.

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE NORTH ALABAMA TOURNAMENT ANGLERS FISHING CLUB, its officers, officials, agents and/or employees, other participants, sponsors, advertisers, and, if applicable, owners and leasees of premises used to conduct the event (RELEASEES), from any and all claims, demands, losses, and liability arising out of or related to any INJURY, DISABILITY OR DEATH I may suffer, or loss or 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, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

X_______________________________ _______________ _______________________________

 Participant’s Signature                                    Age                                          Date

Emergency Contact (Full Name) _________________________________

Phone Number _________________________________________________

FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT TIME OF REGISTRATION)

This is to certify that I, as parent/guardian 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 hold harmless the Releasees from any and all liability incidents 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/Guardian Signature                              Date                    Emergency Phone Number(s)

X_______________________________ _______________ _______________________________

 Participant’s Signature                                    Age                                          Date

Emergency Contact (Full Name) _________________________________

Phone Number _________________________________________________