Make checks payable to: PAC for ARL Mail entries to:
Portland Athletic Club c/o Barb Loch
"Play for the Pets" Tournament
196 US Route One
Falmouth, ME 04105

Name __________________________________	Phone (day) ___________________	(Evening)___________________
Address ________________________________	City_________________________	State _________ Zip _________

 

[ ]Entry Fee: Total enclosed $ _____________________	[ ]I have read & signed the waiver at the bottom
[ ]I have enclosed an additional $ __________________ donation to the animal Refuge League
	How would you rate yourself and/or team?
A=advanced/tournament player	B=some tournament play/above average player
C=average player/recreational player	D=inexperienced/beginner

 

		Circle level
[ ] Women's Singles	[ ] Men's Singles	A  B  C  D
[ ] Women's Doubles	Partner ________________________________  [ ] I want to play, but need a partner	A  B  C  D
[ ] Men's Doubles	Partner ________________________________  [ ] I want to play, but need a partner	A  B  C  D
[ ] Mixed Doubles	Partner ________________________________  [ ] I want to play, but need a partner	A  B  C  D

1. In Consideration of Being Permitted to Participate in Any Way in the Play for the Pets Tournament, A Portland Athletic Club activity, I And/Or My Minor Child, Our Personal Representatives, Assigns, Heirs, and next of Kin:
2. Acknowledge, Agree and Represent That I And/Or My Minor Understand the Nature of Racquet Sports Activities and That I And/Or My Minor Child Are Qualified, in Good Health and in Proper Physical Condition to Participate in Such Activity. I further agree that if at any time I believe conditions or equipment to be unsafe, I and/or my minor child will immdediately discontinue further participation in the activity.
3. Fully understand that: A. Racquet Sports activities involve risks and dangers of serious bodily injury, including permanent disability, paralysis and death ("Risks"); B. These Risks and Dangers may be caused by me and/or my child's own actions, or inactions, the actions or inactions of others participating in the activity, the condition in which the activity takes place, or the Negligence of the of the "Releasee" named Below; C. There may be other risks and social and economic losses either not known to me or not readily forseeable at this time; and I fully accept and assume all such risks and responsibility for losses, costs and damages I and/or my minor child incur as a result of my participation in the activity.
4. Hereby accept and assume all such risks, known and unknown, and assume all responsibility for the losses, costs and/or damages following such injury, disability, paralysis or death, even if caused in whole or in part by the negligence of the "Releasee" named below;
5. Hereby release, discharge and Covenant not to sue Portland Athletic Club, their respective administrators, Directors, Agents, Officers, Volunteers and Employees, other participants, any sponsors, advertisers and Portland Athletic Club, its employees, owners and lessors of premises on which the activity takes place, (Each considered one of the "Releasee" Herein) from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the "Releasee" or otherwise, including negligent rescue operations; and I further agree that if, despite this release and waiver of liability, assumption of risk and indemnity agreement I and/or my child, or anyone on my and/or my minor child's behalf, makes a claim against any of the Releasee, I will indemnify, save and hold harmless each of the Releasee from any litigation expenses, attorney fees, loss, liability, damage or cost which any may incur as a result of such claim.
6. I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.

Signature __________________________________________ Date _____________________