6TH ANNUAL ELEPHANT BUTTE LAKE KAYAK FISHING TOURNAMENT May 17-19, 2019 ENTRY FORM ENTRY FEE: $65.00 per person First & Last Name Mailing Addr ess Physical Address (if di fferent) City / State / Zip Phone Mobile Email Emergency Contact Name Phone Boat Information: Circle vessel description below. Kayak Canoe Rowboat Describe Other: Make Model Length Hull Color T- shirt Size: SM Med LG XLG XXLG Additional T- shirts ($20 each): Size: SM Med LG XLG XXLG (Be sure to include payment for additional shirts with your entry fee Sign up early to be in a special prize drawing Hosted by Zia K ayak Out fit ter s 575.744.4185 Enter early to be included in a drawing for a special prize. By submitting this document and entering the tournament, you are acknowledging that you are signing both an entry form and a waiver of liability. I hereby agree to the terms of this waiver and release. I understand that participation in the Elephant Butte Lake Kayak Fishing Tournament may contain danger and risk of injury to entrants, participants, and the general public.
Transcript
6TH ANNUAL ELEPHANT BUTTE LAKE KAYAK FISHING TOURNAMENT May 17-19, 2019
ENTRY FORM ENTRY FEE: $65.00 per person
First & Last Name
Mailing Address
Physical Address (if different)
City / State / Zip
Phone Mobile Email Emergency Contact Name Phone Boat Information: Circle vessel description below. ��Kayak ��Canoe ��Rowboat ��Describe Other: Make Model Length Hull Color T-shirt
Size: ��SM ��Med ��LG ��XLG ��XXLG
Additional T-shirts ($20 each):
Size: ��SM ��Med ��LG ��XLG ��XXLG
(Be sure to include payment for additional shirts with your entry fee
Sign up early to be in a special prize drawing
Hosted by Zia Kayak Outfitters 575.744.4185
Enter early to be included in a drawing for a special prize. By submitting this document and entering the tournament, you are acknowledging that you are signing both an entry form and a waiver of liability. I hereby agree to the terms of this waiver and release. I understand that participation in the Elephant Butte Lake Kayak Fishing Tournament may contain danger and risk of injury to entrants, participants, and the general public.
6TH ANNUAL ELEPHANT BUTTE LAKE KAYAK FISHING TOURNAMENT May 17-19, 2019
ENTRY FORM ENTRY FEE: $65.00 per person
I understand that the lake, road surface, access ways or lack thereof, lighting or lack thereof and weather conditions all change and may pose a danger to the participants and viewers. I further understand that other participants may pose a danger. Nevertheless, I voluntarily accept all risks in connection with this entry and participation in this Elephant Butte Lake Kayak Fishing Tournament, and hereby release Zia Kayak Outfitters, its owners, agents and employees from all liability for any injury to myself or damage to my property. I agree to indemnify, hold harmless and defend Zia Kayak Outfitters, the organizing committee, and all of its owners, agents, and employees for all liabilities, loss or damage that may be suffered as a result of claims, demands, costs, fees and liabilities of any type of description whatsoever arising from my negligence, errors or omissions, or that of anyone for whom I am responsible. At all times the liability of Zia Kayak Outfitters and the organizing Committee is governed by the provisions of the New Mexico Tort Claims Act. I recognize that future marketing requires use of photography and video. I hereby expressly grant to Zia Kayak Outfitters and the organizing Committee the irrevocable, assignable right and license to take, use, and publish images of participants and images provided by the participants without the need for any other approval or compensation. I also release Zia Kayak Outfitters and the organizing Committee, its agents or assigns, from all claims related to the licenses that have been granted in this release. Signed, executed and application is hereby made to participate in the Elephant Butte Lake Kayak Fishing Tournament. I have read, understood and agree to the terms and conditions as set forth herein above. Participant Signature Date Parent or Guardian Signature for participant under 18 Date Mail entry form and check to the address below or scan and email to [email protected] or fax at (575) 744-4186 with credit card information.
Sign up early to be in a special prize drawing
Hosted by Zia Kayak Outfitters 575.744.4185
Credit Card # Exp Date V-Code Mail to: Zia Kayak Outfitters • PO Box 1482 • Elephant Butte, NM 87935 Kayak Fishing Rentals may be reserved on our website:
