Bucket List Tournament Reservation Agreement

1. Participant(s) Name ______Name ______

Street Address ______City, State, Zip ______

Email ______Cell # ______Emergency Contact Info ______

2. Credit Card Information:

Name on Card: ______

Card Type: MC, VS, AMEX, DVR

Card Number: ______

Expiration Date: ______

CVS Number: ______

Fisherman Signature: ______Date:______

______(initials) If available, I request a single hotel room, I understand that if granted a single room I will guarantee the full cost of the hotel room- $950.00.

3. Acknowledge and Agreement. It is understood by my signature on this reservation form, I ______(“Fisherman”) agree completely with and will abide by and all the terms and conditions of this reservation, and event.

4. GUARANTEE. The per Fisherman guarantee will be as follows: a. Guarantee Amount: $500.00, Guarantee Date: 02/28/13 Charity b. Guarantee Amount: up to $1200.00, Guarantee Date: 03/31/13, Hawks Cay: Room and Boat Charter portion

5. CANCELLATION.

After a Fisherman has made a reservation: a. BEFORE any Guarantee Date expiration listed above, a Fisherman may cancel their reservation without any penalty noted in the Guarantee Amount section. b. AFTER any Guarantee Date expiration listed above, a Fisherman acknowledges they will be financially liable for the Guarantee Amount(s) listed above. Specifically the Fisherman authorizes the use of the card information to pay the Guarantee Amount(s). c. If after the expiration of the Guarantee date, a Fisherman will only be released from their Guarantee Amount, if they provide a substitute Fisherman who has properly executed the RESERVATION AGREEMENT. d. Should for any reason the “substitute” Fisherman fail to meet their financial obligations, the original Fisherman will remain liable for their “Guarantee Amounts”

6. INSURANCE.

It is strongly recommended that the Fisherman purchase travel insurance that can reimburse Guaranteed Amounts (not Charity donation) should the Fisherman for any reason what so ever be unable or unwilling to participate in the Bucket List Fishing tournament including acts of God.

7. EXPENSES.

The tournament organizers are not taking on any financial responsibility on behalf of the fishermen. The organizers efforts have been only to secure reservations for accommodations for the group and fishing charter boats and their captains. All expenses associated with this fishing tournament will be at the carried solely by the Fisherman. Other expenses other than those listed below, although not intending to be complete, maybe as follows: Airfare, Hotel taxes, Hotel transfers/transportation, tips, food, drinks, and spa activities.

Group Reservation Arrangements: Hotel: $950.00 -4 nights, includes continental breakfast, 2 Fisherman to a room. Boat/Capt: $1225.00 per boat for 1.5 days of fishing, TEAM: 2or 3 Fisherman to a boat.

Each Fisherman will pay ½ of the total room expense and ½ or 1/3 of their teams charter expenses. Each Fisherman will be provided an individual room charge account where ½ of the room charge will be accessed, and all the other in hotel charges (dinners, bar, golf, etc) can be charged. Each fisherman can use their credit card as listed above to pay their portion of the charter expense and tip.

All Hotel Rooms will be 2-man occupancy. Should a odd number of Fisherman attend, it is possible that a single room would become available under the FULL ROOM COST provision. Initialing the statement below will not guarantee a single room, but will demonstrate your willing to change your GUARANTEE AMOUNT for the hotel from $475 to $950 should your request for a single room be accepted.

______Initials

7. FISHING TEAMS

c. Formation. Before the “Guarantee Date” Teams are strongly encouraged to form in order to minimize the per person expense of the Charter and the room. Building and Recruiting for your Team is also encouraged before the “Guarantee Date”. NO new reservations will be taken after the Guarantee Date of 03/31/2013 , only substitute fisherman will be accepted as outlined in Section 4.C. d. Right to reassign. The “Organizers” reserves the right to reassign any Fisherman to any Hotel room to fulfill the 2 men per room requirement. The “Organizers” also reserves the right to reassign any Fisherman to another FISHING TEAM in order to meet the 3 men per boat requirement. e. Right to dissolve or cancel. The “Organizers” reserves the right to cancel a Fisherman’s reservation without penalty to the Fisherman in order to achieve the per capita Hotel and Boat requirements. Cancellations would be based upon the last Fisherman to make a reservation or a lottery format. The format will be at the discretion of the “Organizers”. f. Four Man Team Option. The ‘Organizers” reserve the right to place a sole Fisherman with a three man team, to allow the “sole” Fisherman to participate and to achieve the goal of 2 men per room occupancy. The four man team will divide the boat charter cost by ¼ instead of 1/3. The Team will select the one non-countable member of the team each day, and give to the captain before fishing begins.

8. INDEMNIFICATION AND HOLD HARMLESS The Fisherman named above, agrees to Indemnify and Hold Harmless, The “Organizers, the sponsors, the charities, the other fishermen, or others associated with the Fishing Tournament, from an financial, emotional or physical harm, that might or could come to the Fisherman participating in this event.

9. PARTICIPATION

Each fishing team or fisherman may at elect not to participate in the fishing event however if counted as a fisherman, that person will remain liable for their portion of the fishing charter expense. If for any reason a fisherman must leave early, the room and the fishing charter expense will still be billed to the fisherman as it is guaranteed.

10. THE TOURNEMENT ORGANIZERS Specifically named are Mike and Martha Richardson and Cardiovascular Innovation Institute.

11. ENTRY FEE, PRIZE MONEY Each Fisherman will be responsible for bringing $100 cash to the tournament as an ENTRY Fee. Fisherman without their $100 will not participate in the tournament and will remain liable for any and all expenses under the Guarantee Amounts section. All ENTRY MONEY will be paid out as PRIZE Money.

Organizer have the flexibility to change and adapt the Prize money awards based upon fishing conditions.

Organizers can win Prize money awards.

12. RATES

Hotel Room: $211.50/2 queen beds/night Villa: $447.75/night Fishing: $725.00 with gratuity/ day, max 3 fishermen. Box Breakfast: $26.00/meal