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 Kayak
Sportfishing presents the
2nd Annual
Kayak Sportfishing
Tournament - Dana Point
Saturday March 12th,
2005
ENTRY
FORM
Name____________________________________________Email________________________
Address ___________________________________________Phone Number
________________________
City/State/Zip
____________________________________________________________
*Select
a division (circle
only one): [Catch and Release Bass
]
or
[Big Fish
]
The
cost to enter is $30 if you pre-registered before Thurs, March 10th ($40 day of the event).
Please make checks or money orders payable to Kayak Sportfishing.
RELEASE OF LIABILITY
(Clearly print your name)
I ______________________________________________________ am aware that using watercraft including
but not limited to kayaks, exposes me to certain hazards, including but not limited to injury or
death, illness or medical emergency, including the risk of drowning; and damage to loss or theft
of vessel and/or equipment or other personal possessions, during the use of the kayak, including
the transport of the vessel and equipment.
Kayaking and kayak fishing poses significant potential hazards including risk of
injury or death. Each person (s) involved in kayaking or kayak fishing needs to understand
there are potential risks and hazards when kayaking or kayak fishing.
I hereby release,
indemnify and hold harmless Kayak Sportfishing and all of their owners, agents, event
organizers, hosts, officials, sponsors, or anyone else associated with this event from any and
all liabilities, cause of action, claims, demands, costs or debts of any nature, arising out of
negligence or otherwise.
I assume all risks of the kayak and equipment, in transport and use by myself, and all of
the potential hazards and dangerous conditions associated with its use and transport.
I
assume responsibility for all such risks and hazards associated with this event.
Signature:
_________________________________________________ Date: _______________________
Mail signed entry form and payment to:
Kayak Sportfishing P.O. Box 4283
West Hills, CA. 91308
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