“Fishing with Heroes”
LAKE DARDANELLE - BASS FISHING TOURNAMENT
June 11, 2016
BOAT CAPTAIN or ARKANSAS VETERAN
Official Entry Form (print)
The tournament sponsor, officers, employees, agents, etc. will not be responsible for boating or water accidents. Each tournament BOAT CAPTAIN and Veteran contestant shall be solely responsible for his/her actions with regards to inclement weather or other potentially dangerous situations which may arise. The contestant or non-contestant expressly assumes the risk of any and all damage or injury of any nature, which may result from any source whatsoever during the tournament.

All tournament BOAT CAPTAINS and Veteran contestants must read and sign the form entitled “WAIVER & RELEASE”. Your signature on this form will constitute a certification that the contestant has read and understood all terms set forth.

All tournament contestants by their entry applications shall grant permission to the tournament sponsors the right to publicize and/or
broadcast his/her name or image.

Weigh-in will start at 1:00 p.m. Trophies and prizes will be awarded shortly after weigh-in.

Weigh-in & Tournament Director is Frank Leone.

WAIVER & RELEASE FROM LIABILITY-THIS IS A RELEASE Hold Harmless Agreement

In consideration of being permitted to enter for any purpose any RESTRICTED AREA (herein defined as the areas to which admission by the general public or spectators is prohibited), or being permitted to compete, officiate, observe, work for, or any purpose participate in any way in the event, EACH OF THE UNDERSIGNED, hereinafter referred to as “releaser,” for himself, his personal representatives, heirs, next of kin, acknowledges, agrees, and represents that he has, or will immediately upon entering any such restricted areas, and will continuously thereafter, inspect such restricted area or areas and his participation, if any, in the event constitutes an acknowledgement that he has inspected such areas and that he finds and accepts the same as being safe and reasonably suited for the purpose of his use, and he further agrees and warrants that if, at any time, he is in or about restricted areas and he fells anything to be unsafe, he will immediately advise the officials of such and will leave the restricted area(s) and further:
1. HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the “ARKANSAS FREEDOM FUND,” the promoters, other participants, operators, officials, any persons in a restricted area, sponsors, advertisers, owners and lessees of premises used to conduct the event and each of them, their officers and employees, all for the purposes hereinafter referred to as “releasee”, from all the undersigned, his personal representatives, assigns, heirs, and next of kin for any and all damage, and any claim or demands therefore on account of injury to the person or property of resolution in death of the undersigned, whether caused by the negligence of the “releasee” or otherwise while the undersigned is in or upon the restricted area, and/or, competing, officiating in, observing, or working for, or for any other purpose participation in the event.
2. HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the releases and each of them from any loss, liability, damage, or cost they may incur due to the presence of the undersigned in or upon the restricted area or in any way competing, officiating, or working for, or for any purpose participation in the event and whether caused by the negligence of the releases or otherwise.
3. HEREBY ASSUMES FULL RESPONSIBILITY OF ANY RISK OF BODILY INJURY, DEATH, OR PROPERTY DAMAGE due to the negligence of releases or otherwise while in or upon the restricted area and/or while competing, officiating, observing, or working for, or for any purpose participating in the event.
4. EACH OF THE UNDERSIGNED, expressly acknowledges and agrees that the activities at the event and in the restricted areas are
dangerous and involved the risk of serious and/or death and and/or property damage. EACH OF THE UNDERSIGNED further expressly agrees that the foregoing release, waiver, and indemnity is intended to be as broad and inclusive as permitted by the law of the Province or State in which the event is conducted and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full force and effect.
THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY
AGREEMENT, and further agrees that no oral representations, statements, or inducement apart from the foregoing written agreement have been made. This waiver, release and indemnification agreement specifically embraces each and every activity or event in which the undersigned participates so that the parties herein intended to be released and indemnified shall be fully and effectively released and indemnified as to each and every event herein above described.

Print Name,_________________________Signature_________________________ Date _____

Print Witness,_______________________Signature__________________________Date______

BOAT CAPTAIN or COMPETITOR
(Circle One)
Name _____________________ ____________________________

Address _________________________________ City ___________________________ State ____ Zip __________

Telephone ____________________ Emergency Phone______________________

Email: ________________________________________________