21st Annual Orange Beach Spearfishing Tournament
  Sept 22 - Oct 7, 2017

 
Mail to: 4515 5th Avenue South
Birmingham, AL 35222
(205) 595-3052

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 $70.00 (ASA Members) $80.00 (Non-ASA Members)
Includes one short sleeve t-shirt
Additional t-shirts may be purchased for $20.00
Shirt size:________  Additional Shirts___________

__ I will be participating in the FLOUNDER winner take all JACKPOT $25.00
__ I will be participating in the SNAPPER  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 the Safety Meeting.

RELEASE STATEMENT

I, ________________________, in consideration of permission granted me to
participate in this Spearfishing Tournament to be held Sept 22-Oct 7, 2017,
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 _________________ 2017.

Signed ________________________  Witness _______________________

________________________________________________
Signature of parent or guardian if under 21 years of age.