MIDDLE
Tullahoma,
2009 IDPA Southern Regional Championship
May 29, 2010
NAME____________________________________________________________________________ IDPA#_____________________
ADDRESS_________________________________________________________________________________________________________
CITY_________________________________________________________________________STATE__________ZIP_________________
PHONE_______________________________EMAIL_____________________________________________________________________
|
Division: |
CDP |
ESP |
SSP |
SSR |
ESR |
|
Classification: |
NOVICE |
MARKSMAN |
SHARPSHOOTER |
EXPERT |
MASTER |
|
Special: |
High Law |
|
High Senior |
|
High Lady |
|
|
|
Quantity |
Extension |
|
Before May 10 |
$75 (includes lunch) |
|
$ |
|
After May 10 |
$90 (includes Lunch) |
|
$ |
|
Extra Meal Ticket |
$5 |
|
$ |
|
T-Shirt S M L XL |
$15 |
|
$ |
|
T-Shirt XXL |
$16 |
|
$ |
| Sweat Shirt S M L XL | $25 | $ | |
| Sweat Shirt XXL | $27 | $ | |
|
Total |
|
|
$ |
NO REFUNDS AFTER May 14, 2010
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Waiver, Release and Covenant Not to Sue
-----------------------------------------------------------------------------------------
In consideration of the MIDDLE TENNESSEE SHOOTERS CLUB, INC., a
Tennessee corporation hereafter referred to as the MTSC, permitting me
to engage in
firearms shooting activities of the MTSC wherever the same are held, I,
on my own behalf
and on behalf of my heirs, representatives, administrators and assigns,
hereby waive and
release any and all claims, demands, causes of action, suits and rights
I, or anyone on my
behalf, might have against the MTSC, its officers and/or directors for
personal injury
(including death), loss or damage to my property which I (or anyone
claiming by or
through me) may have against the MTSC, its officers and/or directors, as
a result of my
taking part in the firearms shooting activities sponsored by, sanctioned
by or approved by
the MTSC, its officers and/or directors.
Further, I agree that I will not, nor will anyone acting on my behalf
claiming by or
through me, bring or maintain any suit in Court to assert any claim
against the MTSC, its
officers and/or directors, for any claim that I might have arising out
of my participation in
any activities sponsored by, sanctioned by or approved by the MTSC, its
officers and/or
directors.
I UNDERSTAND THAT ENGAGING IN FIREARMS SHOOTING
ACTIVITIES CONSTITUTES MY INVOLVEMENT IN A VERY HAZARDOUS AND
DANGEROUS ACTIVITY WITH ACCOMPANYING RISKS OF PERSONAL
INJURY OR DEATH AND LOSS OR DAMAGE TO PERSONAL PROPERTY, AND I
HEREBY VOLUNTARILY ASSUME THOSE RISKS.
MY SIGNATURE ON THIS DOCUMENT CERTIFIES THAT I AM AT
LEAST 21 YEARS OF AGE AND THAT I MAY LEGALLY POSSESS FIREARMS
AND THAT I WILL NOT USE ANY SKILL I LEARN WHILE PARTICIPATING IN
THE AFOREMENTIONED EVENTS FOR ANY ILLEGAL ACTIVITY.
I have read and understand the foregoing provisions of this Waiver,
Release and
Covenant Not to Sue and I have executed this instrument voluntarily on
this date.
I recognize that the MTSC, its officers and/or directors are not
obligated to permit
me to participate in any of the MTSC s activities and may terminate my
participation in
such activities at any time and for any reason.
The effect of this instrument shall not preclude the prosecution of any
claim that I
might have against persons or corporations other than the MIDDLE
TENNESSEE
SHOOTERS CLUB, INC., its officers and/or directors. In other words, I am
releasing,
waiving my rights and agreeing not to sue the MIDDLE TENNESSEE SHOOTERS
CLUB, INC., its officers and/or directors.
This instrument shall remain in full force and effect indefinitely.
Signed____________________________________________Dated_________________
Print name____________________________Witness_____________________________