A Really Big Dill Pickleball Tourney Registration Form

PICKLE BALL TOURNEY

Sept 16, 2023, 10 am Orchard Hill Park Pickleball Courts, 1701 Primrose, Cedar Falls
TEAM NAME
PLAYER 1
First NameMiddle NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Contact Number
Sex
Age on Event Date
Emergency Contact:

First NameLast Name
Relationship
Contact Number
Tee Shirt Size
PLAYER 2
First NameMiddle NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Contact Number
Sex
Age on Event Date
Emergency Contact:

First NameLast Name
Relationship
Contact Number
Tee Shirt Size
Release and Waiver of Liability - Assumption of Risk and Indemnity Agreement
In consideration of our participation in the pickleball tourney, I, the undersigned participant, hereby acknowledge and agree to the following on behalf of both team players:

We are fully aware of the risks involved in participating in a pickleball tourney and voluntarily assume all such risks.We are physically fit and have no medical conditions that would prevent our participation in the pickleball tourney.We agree to comply with all rules and regulations of the pickleball tourney.We release, discharge, and hold harmless the organizers of the pickleball tourney, their officers, directors, employees, volunteers, sponsors, and any other persons or organizations associated with the Really Big Dill Pickleball Tourney from any and all claims, damages, or injuries, including death, that may arise from our participation in the tourney or as a result of our use of any facilities or equipment provided by the tourney.
Date

MonthDayYear
Date
Signature
Parent/Guardian Signature

If a team member is under the age of 18.
Signature
Payment due at time of registration. To guarantee an event tee shirt, registrations must be received prior to September 5.

Submit registration online and remit payment of $50 per team to La Porte City Speciality Care, PO Box 175, La Porte City, IA 50651.

Event is rain or shine. In the event of severe weather and a cancellation is deemed necesssary for player safety, no refunds will be granted.

All proceeds for this event will be donated to the Alzheimer's Association.
Should be Empty:

PICKLE BALL TOURNEY

PLAYER 1

PLAYER 2

Release and Waiver of Liability - Assumption of Risk and Indemnity Agreement

Parent/Guardian Signature