Registration Form
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| _________________________________________________ | |||
| Name | |||
| _________________________________________________ | |||
| Address | |||
| _________________________________________________ | |||
| City | State | Zip code | |
| _________________________________________________ | |||
| Phone # | |||
| _________________________________________________ | |||
| E-Mail address | |||
| Please mark the division you wish to play in: | |||
By signing this registration form I agree to the following: |
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| Pro Division: | The legal date will be the date this form is submitted for processing. | ||
| __ Open Men | $35 | ||
| __ Masters Men | $35 | "I hereby hold blameless and fully release QuadCityDiscGolf.com and its employees, the tournament directors, local and state municipalities,and all tournament partners/ sponsors and any individuals associated with this tournament from all liability of personal liability or injury which I may incur before, during or after my participation in this event. I accept full and sole responsibility for any damage I may cause through negligence and/or malice, including damages and/or injuries caused by my own throws in practice or competition, as well as damage at any of the venues where event activities are conducted. |
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| __ Grandmaster Men | $35 | ||
| __ Open Women | $35 | ||
| Advanced Division: | |||
| __ Advanced Men [935+] | $30 | ||
| __ Advanced Masters Men | $30 | ||
| __ Advanced Grandmaster Men | $30 | ||
| __ Advanced Women [800+] | $30 | ||
| __ Intermediate Men [900-935] | $25 | ||
| __ Intermediate Women [<800] | $25 | I also recognize that the event sponsors, staff and any other media outlets covering the event have the right and responsibility to record any participants via video and/or still photography. Such photography may be used for event publicity, public information or any other use and without compensation to the participants. | |
| __ Recreational Men [ <900] | $20 | ||
| __ Recreational Women [<750] | $20 | ||
| Junior Division: | |||
| __ Junior Boys 16 & Under | $20 | ||
| __ Ace Fund: $2 (Optional) | Note: A parent or legal guardian must sign if player is under the age of 18 years of age. | ||
| Total Included: $______________ | |||
| Make check or money order payable to: Joe Rodman | |||
| Mail to: 748 Ridgewood Ave. Davenport, Iowa 52803 | |||
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| Sign | |||
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| Date | |||