North Alabama Tournament Anglers
Application to join https://experience.tripster.ru/experience/Moscow/20217-zavody/
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:________________
PARTICIPANT RELEASE OF LIABILITY
NORTH ALABAMA TOURNAMENT ANGLERS BASS FISHING CLUB
PARTICIPANT NAME: (Please Print)
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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.
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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.
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Parent/Guardian Signature Date Emergency Phone Number(s)
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Participant’s Signature Age Date
Emergency Contact (Full Name) _________________________________
Phone Number _________________________________________________