I am from:
(Ex: Charlotte, NC)
MPO Open ($30)
MA1 Advanced ($30)
MA2 Intermediate ($30)
MA3 Recreational ($30)
1 for $5 (+$5)
5 for $20 (+$20)
If under 18, please give your age.
PDGA # (If not applicable, put NONE)
MacIntyre Park Liability Waiver: I acknowledge that my participation is completely voluntary on my part and is being undertaken without promise or expectation of compensation. I, the below-signed, for myself, my heirs, and assigns hereby release and discharge Hands On Thoms County (HOTC), its affiliates, associates, and agents and any participating organizations, for any claims for damages or injury I may incur resulting from my participation in this voluntary event. I understand that my participation involves risk of injury and that illness may result directly or indirectly from my participation. I further state that I am in proper condition for participating in these events. I agree to abide by the rules established by HOTC relative to health and safety requirements. I also give my permission to HOTC to reproduce any photographs or video taken during this project. Signature of participant: ____________________________________ Date: ________________ Signature of Parent or Guardian if participant under 18: ______________________________________________________ If possible, print and bring signed liability waiver with you. You will be asked to submit a signed copy at check-in.
I have read and agree to the terms and conditions outlined in this waiver.