Sample Registration Form (Delete the Events Below That Are Not Offered in Your Tournament)

Sample Registration Form --- (Delete the Events Below that are not offered in your Tournament)

Good Guys Pickleball Tournament

Dates of Play: October 15, 16, 17 20XX Events: women’s singles ____, men’s singles ____, women’s doubles ____, men’s doubles ____, mixed doubles____ Entry Deadline: Entries must be received by ______. Entry Fees: Entry Fees are $______for the first event and $______for each additional event. Please make checks payable to ______. There is a $____ Discount to USAPA Members if you enter your USAPA Card Number below. Mail To: John Doe at Good Guys Pickleball Club at 15016 Good Guys Lane, Good City, AZ 99999 Location: Good Guys Pickleball Club at 15016 Good Guys Lane, Good City, AZ 99999 Format of Play: Indicate here whether events will be double or single elimination, round robin or have consolation rounds. Gender (M or F): ____ Name: ______Last First middle initial USAPA Member Number Address: ______City State Zip Phone #:______Cell Phone #:______Birth date: ______Email Address: ______Emergency Contact: ______Phone #: ______

Total Money Enclosed With Your Entry: $______

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I APPLY FOR ENTRY IN THE FOLLOWING EVENTS ---- (CIRCLE EVENTS AND CHECK BOXES)

Junior Singles | 18&U 16&U 14&U 12&U 10&U  Boy  Girl Junior Doubles | 18&U 16&U 14&U 12&U 10&U Junior Mixed | 18 & U 16 & U 14 & U 12 & U 10 & U . Rated Singles | 5.0 4.5 4.0 3.5 3.0  Man  Woman Rated Doubles | 5.0 4.5 4.0 3.5 3.0 Rated Mixed | 5.0 4.5 4.0 3.5 3.0  . Young Adult/Adult/Senior Singles | 19+ 35+ 50+ 55+ 60+ 65+ 70+ 75+  Man  Woman Young Adult/Adult/Senior Singles | 19+ 35+ 50+ 55+ 60+ 65+ 70+ 75+ Young Adult/Adult/Senior Singles | 19+ 35+ 50+ 55+ 60+ 65+ 70+ 75+ Open Singles | Open Men's Singles Open Women's Singles Open Doubles |  Open Men's Doubles  Open Women's Doubles  Open Mixed Doubles .

Partner's Name Partner's Phone Birth Date USAPA Number Doubles..: ______Mixed ....: ______

Sign and date the waiver on the second page. RELEASE, PERMISSION, AND INDEMNITY AGREEMENT

Waiver. In consideration of being permitted to participate in any way in the Good Guy Pickleball Tournament (“the Tournament”), I, for myself, my heirs or assigns, do hereby release, waive, discharge and covenant not to sue [name of entity sponsoring tournament and/or facility where the tournament is being held], its/their officers, employees and agents from liability from any and all claims resulting in personal injuries, accidents or illnesses (including death) and property loss arising from my participation in the Tournament.

Assumption of Risk. Participation in the Tournament carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks vary, but include 1) minor injuries such as bruises, sprains and dehydration, 2) major injuries such as eye injuries, joint, bone or back injuries, heat stroke, heart attacks, and concussions, and 3) catastrophic injuries such as paralysis and death. I have read the previous paragraphs and I know, understand and appreciate these and other risks that are inherent in playing pickleball. I assert that my participation is voluntary and that I knowingly assume all such risks.

Indemnification and Hold Harmless. I also agree to indemnify and hold the Good Guy Pickleball Tournament [add others as desired] harmless from any and all claims, actions, suits, costs, expenses, damages and liabilities, including attorney’s fees brought as a result of my involvement in the Tournament.

Use Permission. I also give the Good Guy Pickleball Tournament and its agents and designees permission to use or distribute, without limitation or obligation, my image, name, voice, and words for any purpose connected with the Tournament, including promotional, marketing, training, informational, and archival uses.

______Signature of Participant Print Name of Participant Date

______Signature of Parent/Guardian if Minor Print Name of Minor’s Parent/Guardian Date Minor’s Age