Application and Release Statement
Name________________________________________________________Telephone _______________
Address___________________________________________________________________________________
City_____________________________________________________State___________Zip________
Team Affiliation_________________________________________
SCUBA APPLICANTS MUST PROVIDE THE FOLLOWING INFORMATION
Certifying Agency and
Number__________________________Years Experience_____
_____ I will be competing as a NOVICE (certified less than 3
years)
_____ JACKPOT $25.00 per Flounder _____
Snapper_____
Registration fee is $70.00. This includes one T-shirt
Additional T-shirts may be purchased for $15.00.
SHIRT SIZE: Med.____ or Large_____ or X-Large____ or XX-Large _____
Total amount enclosed: $___________ Mail to address at top of letterhead.
Please enclose this form and mail with payment to the
address above. Mailed registration must be received no later
than
(Safety Meeting). The Safety Meeting will be held at
Original Oyster House in
Mobile Alabama located on Battleship Parkway. You may also
register at any participating dive shop.
RELEASE STATEMENT
I,___________________________, in consideration of
permission granted me to participate in the Alabama Open
Spearfishing Rodeo to be held on Aug 11-13, 2017, do hereby
agree that I will not hold any official connected with
said tournament responsible for any accident or damage to me
or my property which may occur during said tournament.
Done this _____ day of _________________ 2017.
Signed___________________________ Witness________________________
________________________________________________
Signature of parent or guardian if under 18 yrs.