Registration Form 

Name of Angler/Anglers:__________________________________________ Age:________ 

Address:____________________________________________________________________ 

Phone:_____________________ Name of Adult:___________________________________ 

E-mail:_____________________________________________________________________ 

Pre-registration is $5 per angler.  

Please make checks payable to Daniel Island Inshore Fishing Club and send to Suzie Twitchell, Treasurer, 1402 Elfe Street, Daniel Island, SC 29492. Waiver below must be signed and dated to complete pre- registration. Questions? Call Fred Danziger at 516-524-2208. 

Daniel Island Inshore Fishing Club Kids Fishing Tournament 

WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT 

1. In consideration for receiving permission to participate in the Daniel Island Kids Fishing Tournament (the “Tournament”) on June 17, 2017, I hereby release, waive, discharge and covenant not to sue the Daniel Island Inshore Fishing Club, its officers, servants, agents and employees (hereinafter referred to as "releasees") from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or relating to any loss, damage or injury, including death, that may be sustained by me, my child, or to any property belonging to me, whether caused by the negligence of the releasees, or otherwise, while participating in the Tournament. 

2. I am fully aware of risks and hazards connected with participating in the Tournament and voluntarily assume full responsibility for any risks of loss and hazards unknown to me connected with participating in the Tournament. 

3. I further hereby agree to indemnify and save and hold harmless the releasees and each of them, from any loss, liability, damage or costs they may incur due to my participation or my child’s participation in the Tournament, whether caused by the negligence of any or all of the releasees, or otherwise. 

4. It is my express intent that this Release shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a Release,Waiver, Discharge and Covenant Not to Sue the above named releasees. 

In signing this release, I acknowledge and represent that: 

A. I have read the foregoing release, understand it, and sign it voluntarily as my own free act and deed; 

B. No oral representation, statements or inducements, apart from the foregoing written agreement, have been made; 

C. I am at least eighteen (18) years of age and fully competent; and 

D. I execute this Release for full, adequate and complete consideration fully intending to be bound by same. 

Signature: ______________________________________________ 

Name Printed: ___________________________________________ 

Date: __________________________________________________