11th Annual 5Rivers Tournament
WAIVER/ RELEASE OF LIABILITY
When agreeing to the waiver, the participant (or parent or guardian) agrees to and understands the following
1) All participants represent that they are physically and mentally competent, and fit and able to participate. By entering all participants agree to indemnify and hold MBKFA and all its officers, members, agents, and sponsors harmless from and against all claims, liabilities, and causes of action resulting directly or indirectly or indirectly from participation
2) Acknowledges and fully understands that he or she will be engaging in activities that involve risk of serious injury, including permanent disability and death, not only from his/her own actions, inactions, and negligence of others and the condition of the equipment used. Furthermore, there may be risk known to us or not reasonably foreseeable at the time.
By checking "YES" below, the participant (or parent or guardian) understands that he/she has given up substantial rights by checking "YES" and does so voluntarily
Do you agree to the waiver?
Additional Shirt $20
Please specify additional shirt size if different from size above
Emergency Contact Name
Emergency Contact Number
NEW THIS YEAR!
To be eligible for the flounder jackpot, you must purchase the flounder jackpot ticket. Tickets will be available on this form, or can be purchased before or during Capt. meeting at Bass Pro Shops. You must be on the list as a participant in the jackpot to win. Heaviest flounder weighed from Jackpot participants will be considered the winner. Winner will collect all money paid into Jackpot. 100% payout!
Flounder Jackpot Entry $10
Yes I want to participate in the Flounder Jackpot
Do Not Fill This Out