Official Entry
Form ENTRY FEE: $125 PER TEAM $10 Big Bass Pot
Please Print This Form and Mail to Address Below
Current Member:________YES _______ NO
My Membership Expires: ______________________
Non Members can join at lake or send $75 with entry
Name (1)_____________________________________________________________
Address _____________________________________________________________
City/State/Zip
________________________________________________________
Telephone
__________________________ SS#_____________________________
Email Address:
_______________________________________________________
Current Member:________YES _______ NO
My Membership Expires: ______________________
Non Members can join at lake or send $75 with entry
Name (2)_____________________________________________________________
Address _____________________________________________________________
City/State/Zip
________________________________________________________
Telephone
__________________________ SS#_____________________________
Email Address:
_______________________________________________________
PARTICIPANT AGREEMENT, RELEASE, AND ACKNOWLEDGMENT OF RISK
In consideration of Arkansas Couples Tournaments allowing me to participate
in this tournament, I acknowledge and agree as follows:
1. I have read and understand the description of the tournament and the
Official Rules of this tournament. I will obey all rules and understand that any violation may result in immediate disqualification without refund of my entry fee. I also understand that tournament officials may reject my application for any reason and in that event will refund my entry fee.
2. I understand and acknowledge that competitive fishing is a dangerous
sport, the risks of which include, though not exclusively, drowning, collisions in the water, and injuries from hooks and other fishing paraphernalia. I
voluntarily assume responsibility for these risks, identified and not identified, and all risk of injury or death or damage to myself or my property or to others, including spectators and their property, arising from my participation in the tournament.
3. I hereby release, discharge, and agree to hold harmless and indemnify
Arkansas Couples Tournaments, it's shareholders, officers, directors, agents and employees, the host, sponsors and tournament officials, and it's partners,
agents or employees, and all other persons or entities associated with the
tournament from any and all liability, claims, demands, actions or rights of action which are related to, arise out of, or are in any way connected with my
participation in this tournament, including specifically but not limited to the
negligent acts or omissions of Arkansas Couples Tournaments, it's shareholders,
officers, directors, agents and employees, the host, sponsors and tournament
officials, and it's partners, agents or employees and all other persons or
entities associated with the tournament, for any and all injury, death, illness or disease, and other damage or loss to property suffered by myself or others. In signing this document, I acknowledge and agree that if anyone is hurt or
property is damaged while I am engaged in this event, I will have no right to make a claim or file a lawsuit against Arkansas Couples Tournaments, it's
shareholders, officers, directors, agents or employees, the host, sponsors, officials and all other persons or entities associated with the tournament, even if they or any of them negligently caused the bodily injury or property damage.
4. Any suit brought by me against Arkansas Couples Tournaments as a result
of my participation in this tournament will be brought in state or county court
in No. Little Rock, AR., where the principal office of Arkansas Couples
Tournaments is located. Should it become necessary for Arkansas Couples Tournaments or someone on it's behalf, to incur attorney's fees and costs to enforce this agreement, or any portion thereof, I agree to pay the reasonable costs and attorney's fees thereby expended, or for which liability is incurred.
5. I have sufficient health, accident and liability insurance to cover any
bodily injury or property damage incurred by myself or others as a result of my
participation in this event. If I have no such insurance, I represent that I
am capable of paying for any and all such expenses or liability.
6. I have no past or present medical or psychological condition that might
affect my participation in the tournament in such a way as to cause harm to
myself or others.
7. I give Arkansas Couples Tournaments permission to use my name and
photograph for promotional purposes. I agree to submit to and accept the results of the polygraph test given at this event. I am currently a member in good standing of Arkansas Couples Tournaments. My signature below reflects that I have read this entire document, understand it completely, understand that it affects my legal rights, and agree to be bound by it's terms. References herein to "I", "my", "myself", and other first person references shall include any child or ward for whom I sign.
(1)___________________________________(2)__________________________________
Signatures (Must be signed by both contestants)
| ______ We are current
members of Arkansas Couples Tournaments |
|
| ______ We wish to join
Arkansas Couples Tournaments ($75 Annual Membership) |
$_________ |
| ______ Enclosed is our
$125 Entry (mailed 6 days prior to event) |
$_________ |
| $______ Enclosed is our Big Bass Pot
|
$_________ |
LAKE______________________________________TOTAL
ENCLOSED $_______________
Complete and Mail Entry
Form with check/money order Vince Miller 6506 Warden Road Sherwood Ar, 72120
(501) 834-5733
|