Surf Shack Surf Series Entry Form ‘07


Name                                                                                                                Circle Division
Address                                                                                                         - Runtz (11yrs & under)
City                                                                                                               - Boys (12-14yrs)
Age (as of 8/30/07)                                                                                         - Jr Mens (15-17yrs)
Phone #                                                                                                         - Open Girls (17yrs & under)

                                                                       Limited to first 40 entrants
                                                                               $10 entry fee
                                                             Make Checks payable to the Surf Shack
                                       Entry Deadline: One day before each contest (NO BEACH ENTRIES!!)
                                               Mail to: 2912 Long Beach Blvd. Ship Bottom, NJ 08008


By signing this waiver, I, and the intending to be legally bound, acknowledge that the Surf Shack Series Contests does exist. I
promise to inspect the contest site, assure myself that the area is safe for surfing, and further agree that I will not surf in the
contest unless I am satisfied that the area and the conditions are safe for surfing purposes. Surfing is dangerous sport, and
hazards such as hidden rocks, rip currents, sea life, and other dangers that come with the sport of surfing do exist. We fully
recognize and understand the nature and existence of these inherent risks. In the event of an injury to my
child/dependent/myself, (including my heirs and assigns), I herby waive, hold harmless, and forever discharge from any
liability damages or claims for damages for personal injury, including accidental death, as well as claims of property damage
against the Surf Shack, its owner, its director, any employees, any sponsors connected with the event, the township in which
the event is held, any lifeguards supervising the event, and the state of New Jersey. I also understand that any disruptive or
damaging behavior on my part or the part of my child/dependent will be due cause for dismissal from this event, with no
refund.     

Signature: