1. Contestant: Member #:
DATE
Age
As of Jan
1,2013 GT GR PB BR Total
Division:
3-June
10-June
17-June
24-July
1-July
8-July
15-July
22-July
29-July
4-Aug
Release of Liability & Participation Agreement
The undersigned agrees as a condition of participation in this activity, to release, save harmless,
defend, protect, and indemnify any person and or organization in any way associated therewith
and their agents, members, officers, and directors form loss, damages, or liability of any sort
arising out of or in any way relating to said activity. If the participant is a minor, the undersigned
parent or guardian acknowledges that they have read this agreement and agrees to be bound by its
terms as a releaser and a guarantor and an indemnitor of said person and/or organizations and
their agents, members, and directors of said minor place and stead. I waive all rights that I have
now or may have as virtue of Section1542 of the California Civil Code, which reads, a general
release does not extend to the claims which a creditor does not know or suspect to exist in his favor
at the time of executing the release at the time of executing his release, which is known by
him/her, must have materially affected his/her settlement with the debtor.
Contact Information:
Telephone #_________________________email address_________________________________________
Signature of Participant: ____________________________________________ Date _______-____/2013
Name of Participant: ____________________________________________ DOB________________
If under the age of 18: __________________________________________________________________
Signature of Parent or Guardian
