! ! ! ! Presents:
The Flagler Surf Series EventsLLC
# 6 September 20 - 21, 2014 South Side Flagler Beach Pier
Name/Team Name:________________________Date of Birth:____________________
Address:____________________________City:_______________________________
State:_________Zip:__________Phone Number:______________________________
Emergency Contact:_____________________________________________________
Any Known Allergies or Pertinent Health Issues:________________________________
Check Divisions:
Men Pro:____________Women Pro:______________ Bodyboard Pro:_____________
Bodyboard:______ Novice:_____ Open Men:_____Locals ONLY:_____ Women:_____
Junior Men 16&-:____________ Tug-Of-War :____________ Corn-Hole :__________
Pro $100 (CASH ONLY) Novice $10 Locals ONLY $10 All Other $25
Total Entry Fee:________________
(Checks for all non PRO payable to THE FLAGLER SURF SERIES EVENTS LLC)
Hold Harmless Release:This release bars your rights to recover damages in the case of an accident injuring you. READ BEFORE SIGNING! In
applying to The Flagler Surf Series Events LLC competitions/tournaments , I promise to inspect the contest site and assure myself that the area is safe
for surfing and further agree that I will not participate unless I am satisfied that the area and conditions are safe to participate in the divisions I have
entered. In exchange for The Flagler Surf Series Events LLC accepting my entry form, I voluntarily agree to assume all risks incident to the divisions
entered. I fully understand and comprehend the dangers of surfing created by the sharp edges and fins along with the natural buoyancy of a surfboard
when they are acted upon by the powerful forces of the ocean and ocean waves. I fully understand and comprehend the dangers of the Tug-Of-War
rope when it is acted upon by the strain of a 5 human team in the action of Tug-Of-War. I fully understand and comprehend the dangers of Corn-Hole. I
fully understand the and comprehend the dangers of digging by hand on the beach in search of the buried product of the Treasure Hunt Sandbox. With
full knowledge , comprehension and understanding of these dangers , I voluntarily accept and assume all risks involved in each division I have entered.
I will further read and comply with all The Flagler Surf Series Events LLC rules and regulations , noting existing weather conditions, and do agree that I
voluntarily assume all risks arising from conditions related to the competition site by myself and others. In consideration of your acceptance of my
entry , I intend to be legally bound , hereby, for myself , my heirs ,executers ,and administrators , hold harmless and release and forever discharge The
Flagler Surf Series LLC ,its directors , the City of Flagler Beach Florida , the State of Florida , Flagler County Florida and all The Flagler Surf Series
Events LLC sponsors , their members , agents and any other officials connected with this competition, from all liabilities for injuries and damages
whatsoever, arising from my presence or participation in the above described event and do hereby grant the sponsors such release as described
herein. I acknowledge that I have read and understand all of the above.
Contestant Name (Print):__________________________________________________
Contestant Signature:____________________________________________________
Under 18 ONLY:
Name of Parent of Guardian (Print):_________________________________________
Signature of Parent or Guardian:____________________________________________
I HEREBY CERTIFY that I am the parent or legal guardian of the competitor named above and do hereby give my
permission without reservation and with full understanding and comprehension of the foregoing agreement to hold the
aforementioned organization and government entities harmless any and all liabilities including , any such injuries
which were alleged to have occurred as a result of negligent failure of The Flagler Surf Series Events LLC officials
judges and directors to properly supervise contestants in the course of competition.
Mail Entries To: The Flagler Surf Series Events LLC
! ! 56 Edward Drive
! ! Palm Coast , FL 32164
The Flagler Surf Series EventsLLC
# 6 September 20 - 21, 2014 South Side Flagler Beach Pier
Name/Team Name:________________________Date of Birth:____________________
Address:____________________________City:_______________________________
State:_________Zip:__________Phone Number:______________________________
Emergency Contact:_____________________________________________________
Any Known Allergies or Pertinent Health Issues:________________________________
Check Divisions:
Men Pro:____________Women Pro:______________ Bodyboard Pro:_____________
Bodyboard:______ Novice:_____ Open Men:_____Locals ONLY:_____ Women:_____
Junior Men 16&-:____________ Tug-Of-War :____________ Corn-Hole :__________
Pro $100 (CASH ONLY) Novice $10 Locals ONLY $10 All Other $25
Total Entry Fee:________________
(Checks for all non PRO payable to THE FLAGLER SURF SERIES EVENTS LLC)
Hold Harmless Release:This release bars your rights to recover damages in the case of an accident injuring you. READ BEFORE SIGNING! In
applying to The Flagler Surf Series Events LLC competitions/tournaments , I promise to inspect the contest site and assure myself that the area is safe
for surfing and further agree that I will not participate unless I am satisfied that the area and conditions are safe to participate in the divisions I have
entered. In exchange for The Flagler Surf Series Events LLC accepting my entry form, I voluntarily agree to assume all risks incident to the divisions
entered. I fully understand and comprehend the dangers of surfing created by the sharp edges and fins along with the natural buoyancy of a surfboard
when they are acted upon by the powerful forces of the ocean and ocean waves. I fully understand and comprehend the dangers of the Tug-Of-War
rope when it is acted upon by the strain of a 5 human team in the action of Tug-Of-War. I fully understand and comprehend the dangers of Corn-Hole. I
fully understand the and comprehend the dangers of digging by hand on the beach in search of the buried product of the Treasure Hunt Sandbox. With
full knowledge , comprehension and understanding of these dangers , I voluntarily accept and assume all risks involved in each division I have entered.
I will further read and comply with all The Flagler Surf Series Events LLC rules and regulations , noting existing weather conditions, and do agree that I
voluntarily assume all risks arising from conditions related to the competition site by myself and others. In consideration of your acceptance of my
entry , I intend to be legally bound , hereby, for myself , my heirs ,executers ,and administrators , hold harmless and release and forever discharge The
Flagler Surf Series LLC ,its directors , the City of Flagler Beach Florida , the State of Florida , Flagler County Florida and all The Flagler Surf Series
Events LLC sponsors , their members , agents and any other officials connected with this competition, from all liabilities for injuries and damages
whatsoever, arising from my presence or participation in the above described event and do hereby grant the sponsors such release as described
herein. I acknowledge that I have read and understand all of the above.
Contestant Name (Print):__________________________________________________
Contestant Signature:____________________________________________________
Under 18 ONLY:
Name of Parent of Guardian (Print):_________________________________________
Signature of Parent or Guardian:____________________________________________
I HEREBY CERTIFY that I am the parent or legal guardian of the competitor named above and do hereby give my
permission without reservation and with full understanding and comprehension of the foregoing agreement to hold the
aforementioned organization and government entities harmless any and all liabilities including , any such injuries
which were alleged to have occurred as a result of negligent failure of The Flagler Surf Series Events LLC officials
judges and directors to properly supervise contestants in the course of competition.
Mail Entries To: The Flagler Surf Series Events LLC
! ! 56 Edward Drive
! ! Palm Coast , FL 32164