1st Annual Pleasure Island
Spearfishing
Classic
September 17 - October 15, 2011
Mail
to: 6721
David Dr S
Theodore, AL 36582
Application and
Release Statement
Name
_________________________________ Telephone ________
Address
_________________________________________________
City
____________________________ State ____ Zip ________
Team
Affiliation __________________ Date of Birth _________
Email
Address_____________________________________________
SCUBA
APPLICANTS MUST PROVIDE THE FOLLOWING INFORMATION
Certifying
Agency and Number ______________ Years Experience _____
Registration is $60.00
and includes one high quality short sleeve t-shirt
Additional t-shirts may be purchased for $15.00
Shirt size:________ Additional Shirts___________
__ I will
be participating in the AMBERJACK winner take all
JACKPOT $25.00
__ I will be participating in the FLOUNDER winner take all JACKPOT
$25.00
__ I will be participating in the GROUPER winner take
all JACKPOT $25.00
__ I will be participating in the SNAPPER winner take all
JACKPOT $25.00
__ I will be participating in the TRIGGERFISH winner take
all JACKPOT $25.00
Total amount enclosed: $ _______ Make checks payable to: Ala.
Spearfishing Assn.
Please enclose this form and mail with "non refundable" payment to
the address at
the top of this page. Mailed registration must be received
no later than Sep 14, 2011.
RELEASE STATEMENT
I, ________________________, in
consideration of permission granted me to
participate
in this Spearfishing Tournament to be held Sep 17 - Oct 15, 2011
do hereby agree that I will not hold any official
connected with said tournament
responsible for any accident or damage to me or my property which may occur during
said tournament. I have read, fully understand and agree to the
rules of this contest.
Done this
_____ day of _________________ 2011.
Signed
________________________ Witness _______________________
________________________________________________
Signature of parent or guardian if under 21 years of age.