Waiver of Claim Release and Indemnification Agreement in consideration of the acceptance of my entry in the Geraldton Walleye Classic, its promoters, employees, sponsors, organizers, hosts, directors, officers, and all other organizers and affiliated organizations, agencies and/or agents and assignees and any other person assisting in this event from any claims for damages or injuries suffered by me as a result of my participation in or traveling to or from this event. I herby state that I am in proper physical condition, and carry proper insurance, to participate in this event and am aware that participation could in some circumstances, result in physical injury. I further agree to indemnify Geraldton Walleye Classic, et. al. (mentioned above), from any claims or damages arising out of or in consequence of the participation or  attendance by me in this event. If under the age of eighteen this waiver of claim, release and indemnification agreement must be signed by a Parent or Legal Guardian.
 
 Entry and Acknowledgement: Having read the rules and regulations, I herby submit my entry form for registration and enclose my entry fee payable to ‘Kenogamisis Fish and Game Club’. By signing this form I agree with the rules and agree to abide by said rules, and allow my name and picture to be published on the World Wide Web and in any print publication the tournament wishes.

2012 Registration Fee - $200

By cheching the box below I certify that I  have read and agree with the above statement: