In order to participate in these activities, I the undersigned agree and acknowledge that:
there is risk of injury, including a potential for permanent disability or death resulting from participation in
these activities or from the equipment involved,
I freely assume all such risks both known and unknown and assume full responsibility for my participation,
I have read and understand the rules, including all safety related rules, and agree to fully comly with all
regulations during my participation,
I, for myself and on behalf of my heirs, assigns, personal represetatives and next of kin hereby release
and hold harmless PENINSULA PREMIER PRO SHOP
their officers, officials, agents and or employees, from any and all liability for injury, disability, death, loss or
damage to personal property,
I acknowledge, understand and agree that I have read this release of liability and assume all risk
associated with participating and that I sign this release of liability voluntarily and without inducement.
PARTICIPANT'S NAME (please print) PARTICIPANT'S SIGNATURE
HOME ADDRESS PHONE NUMBER
MINOR AGED PARTICIPANTS
All players under the age of 18 at the time of participation must have a parent or gaurdian sign below.
I certify that I am the parent or gaurdian with legal responsibility for the above signed participant and agree
to his/her release. I also agree to indemnify the above named companies and individuals from all
liabilities resulting from his/her participation in these activities for myself, my heirs, assigns and next of kin.
PARENT/GAURDIAN'S SIGNATURE DATE SIGNED