Tournament Application
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I CERTIFY THAT THE SOCIAL SECURITY NUMBER SUBMITTED IS CORRECT AND THAT I AM NOT SUBJECT TO BACK-UP WITHHOLDING TAX.
You must sign a release form before each tournament.
MAIL TO:__F.O.C.A.S. ___________________One Time Member open
Fee
1909 South Illinois Street __
________$20.00 check here o
Belleville, IL 62220
Please Check If Spouse If Child o Child's Age______________
Registration Amount___________________Big Bass _______________
MasterCard oVisa o American Express o TOTAL_____________
Card#_________________________________Expiration____________
LAKE______________________DATE OF TOURNAMENT__________
CONTESTANT ONE: SS#
__________________Check If
Alternate o
ALTERNATE FOR____________________________________________
NAME______________________________________________________
ADDRESS___________________________________________________
CITY_____________________________STATE______ZIP___________
PHONE #
___________________________________________________
SIGNATURE_________________________________________________
CONTESTANT TWO: SS# __________________Check If Alternate o
ALTERNATE FOR____________________________________________
NAME______________________________________________________
ADDRESS___________________________________________________
CITY_____________________________STATE______ZIP___________
PHONE #
___________________________________________________
SIGNATURE_________________________________________________
All
returned checks subject to $30.00 fee to F.O.C.A.S. and legal fees if
necessary!
Read the tournaments rules before continuing.
A.
LIABILITY RELEASE. In signing this agreement, I hereby release The Federation Of
Christian Anglers & Sportsmen Inc./F.O.C.A.S., its officers, agents,
employees and sponsors (herein referred to as, The Federation Of Christian
Anglers & Sportsmen Inc./F.O.C.A.S., et al) from all damages, claims,
demands, costs or expenses relating to injury of any persons or any property
which I may sustain or which I may cause by reason of participating in or in
connection with this tournament. I understand that by participating in this
tournament that I may cause or sustain injury including but not limited to: loss
of life, loss of limbs, paralysis, coma, loss of mental functions, loss of
sight, loss of speech/smell, dehydration, exposure, hypothermia, frostbite, sun
stroke and all other injuries that may be caused in a boating accident and/or
exposure to the elements. I further release The Federation Of Christian Anglers
& Sportsmen Inc./F.O.C.A.S., et al for all damages relating to adverse
weather conditions while participating in this tournament. It is my
responsibility to seek safety should adverse and/or unforeseen weather
conditions occur prior to, during or after the tournament.
B. COVENANT NOT TO SUE AND WAIVER
OF SUBROGATION. I further agree that I will
never sue The Federation Of Christian Anglers & Sportsmen Inc./F.O.C.A.S.,
et al for damages on account of any injury, death or damage I suffer or cause
whether known now or which may develop in the future. In the event The
Federation Of Christian Anglers & Sportsmen Inc./F.O.C.A.S., et al are sued
because of my actions, I expressly agree to indemnify and hold The Federation Of
Christian Anglers & Sportsmen Inc./F.O.C.A.S.,, et al harmless from any
liability whatsoever, including court costs and attorney's fee, arising with
respect to such actions. I understand that in waiving my rights to sue The
Federation Of Christian Anglers & Sportsmen Inc./F.O.C.A.S., et al I am also
waiving the rights of recovery from The Federation Of Christian Anglers &
Sportsmen Inc./F.O.C.A.S., et al of my insurance carrier for any claims they may
pay on my behalf.
C. VERIFICATION OF LIABILITY
INSURANCE.
I maintain a minimum of $100,000 liability insurance on the
boat I will use in this tournament.
D.
POLYGRAPH/VOICE STRESS TEST. Failure to take or pass the polygraph/voice stress examination
will result in immediate disqualification without recourse. Random testing may
be given at anytime by tournament Officials to any contestant, with or without
protest being filed.
E. LIKENESS/PHOTO RELEASE: In consideration for permission to participate in the Tournament,
I ("Contestant") hereby grant to The Federation Of Christian Anglers &
Sportsmen Inc./F.O.C.A.S., its assignees and/or licenses (collectively
"Sponsors"), the unconditional right to use my name, voice, photographic
likeness, biographical information, fishing tips and/or instructions in any
medium whatsoever, including but not limited to video/audio productions,
merchandising, promotions, articles, and/or press releases, in connection with
The Federation Of Christian Anglers & Sportsmen Inc./F.O.C.A.S., and/or the
The Federation Of Christian Anglers & Sportsmen/F.O.C.A.S. Tournament Trail,
without restriction as to changes or alterations from time to time. I understand
that I will not be entitled to receive any royalties or other compensation in
connection with such use.
F. I SIGNIFY
by my signature that I have
read all tournament rules and this liability release and agree to abide by all
rules, regulations, releases and tournament official's
decisions.