Kayak-Fishing Tournament – Nov 8, 2014 2014 Tournament Entry Form Sponsored by Everything Kayak, City Of Moss Point Please print clearly Last Name ___ _____ First Name Male Age Under 18 _________ Female 18–24 25-34 Phone Contact: Home 35-44 45-54 55-64 Work Over 65 Cell Address City State_ E-mail ____________ ZIP We do not release e-mail addresses w/out permission *** Emergency Contact Information – Required*** Name __ Kayak Information: Make Phone or Model Color By submitting this document, entering the tournament or participating in any Everything Kayak events, 1. You are acknowledging receipt of and agreement to abide by all Tournament Rules and Regulations and also acknowledge that you are of adult age and under no incompetency. 2. You acknowledge and fully understand that you will be engaging in activities that involve risk of serious injury including permanent disability and death which might result not only from your actions, inactions and negligence but the actions of, inactions and negligence of others or the condition of equipment used. Furthermore, there may be risks not known or not reasonably foreseeable. 3. You assume the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death, as well as the risks associated with loss of or damage to property. 4. You agree to indemnify and hold harmless Everything Kayak and its officers, directors, and members, harmless from and against any and all claims arising out of your participation in the event. Signature: _______ Date: _ (under 18, must be signed by Parent or Guardian) Registration Entry Fee Pre-registration: $35.00 through midnight October 31 $40 Through midnight Nov 6 Late registration: $45.00 on site Nov 7, 4pm until 6:30pm We accept Visa /Mastercard / ~ Cash or Check/ paypal Registration courtesy of Everything Kayak LLC –- Creosote Rd Gulfport, MS 39503 EK Use only Date Paid ____ Time Paid ____ Kayak-Fishing Tournament – Nov 8, 2014 2014 Tournament Entry Form Sponsored by Everything Kayak, City Of Moss Point www.everythingkayak.com - PH# 228-865-1000 EK Use only Date Paid ____ Time Paid ____