skimboard entry form - Coastal Edge East Coast Surfing

EAST
E
G
D
E
L
A
T
S
A
ND ANNUAL CO
2
THE 5
S
T
N
HIPS
E
S
S
E
N
R
IO
P
P
S
M
A
H
VAN
GC
COAST SURFINTH
TH , 2014
4
2
–
7
1
AUGUST
M
R
O
F
Y
R
T
N
E
D
R
A
SKIMBO
posted
edules will be
h
sc
t
a
e
h
d
n
divisions
.org
hedules a
rs in all other
www.surfusa
to
ompetition sc
t
ti
C
a
e
:
p
d
N
n
m
O
a
o
TI
h
c
TI
c
E
4
P
a
COM
the be
to the top
each day on
will awarded
s
tered.
ie
h
p
o
Tr
h
uatc
ach event en
e
Sq
r
y
fo
b
0
e
.0
rs
5
u
3
$
p
00.00
UR FEE:
, Suite 103
AWARDS:$1,0
tered. AMATE
n
e
t
n
e
v
e
Jensen Drive
h
2
c
1
1
a
1
e
r
SC
fo
C
0
E
.0
$85
ail to CE
tion.
ENTRY FEES:
E ECSC and m
AL EDGE loca
C
ST
A
to
t
O
u
C
o
y
ks
n
c
a
forms at
y’s
: Make che
e for late entr
pick up entry
fe
o
ls
0
PAYMENT INFO
a
1
$
y
.
a
th
m
3
1
u
- Yo
August
h, Va. 23451
no later than
d
e
or
rk
a
m
Virginia Beac
st
o
p
irginia Beach
ail-ins
V
m
.,
r
o
St
st
th
1
9
2
1
6
st
1
gu
ted at 2
th.
DEADLINE: Au
an August 22
AL EDGE loca
th
ST
r
A
te
O
la
C
t
o
a
n
t
1
n
5
, Va. 234
y/payme
irginia Beach
Drop-off entr
V
3
0
1
e
it
Su
,
22ND
e
2 Jensen Driv
FF IS AUGUST
1
O
1
1
TU
C
SC
C
N
E
O
E
TI
C
REGISTRA
ATION - LATE
TR
IS
G
E
R
H
C
NO BEA
52nd
SKIMBOARD ENTRY FORM
(Please check each event you will compete in as of your age on August 19th, 2014)







Mini (8 & under)
Menchune(9-11)
Boys (12-14)
Juniors (15-17)
Mens (18-21 )
Men (22-24)
Masters (25-29)
**SHIRT SIZE:
 Youth M







 Youth L
Grandmasters (30-39)
Sr. Grandmasters (40 & up)
Professional
Girls (1-14)
Women (15 & up)
Women (18+)
Semi Pro
 Adult S
 Adult M
 Adult L
Adult XL
Name:
Phone:
Age:
Email address:
Address:
City:
State:
Zip:
In consideration of acceptance of my application to the 52nd Annual CE ECSC, I hereby release the Virginia Beach Jaycees, Resort Management, LLC,
their members , the United States Surfing Federation (USSF), their members, the city of Virginia Beach, all sponsors, agents, successors and assigns any
other person or organizations officially connected with their competition from liability for and all injuries or damages whatsoever arising from my
participation or presence at their event. I also give my release for the use of photos, film or video taken of me at this event. I fully understand that I will
be disqualified from the competition if I am found guilty of any rules violation, without refund of entry fees. In addition, I am responsible for keeping
posted of any changes in the schedule times.
Contestant Signature:
Date:
FOR CONTESTANTS UNDER 18 YEARS OF AGE: I HEREBY CERTIFY, that I am parent or guardian of the participant named above, and do hereby give
my permission without reservation and with full understanding and comprehension of the foregoing agreement to hold the aforementioned
organizations and government entities harmless of any and all liabilities including any such injuries which are alleged to have occurred as a result
of negligent failure of CE ECSC officials, judges, and directors to properly supervise contestants in the course of competition.
Parent/Guardian Signature: (if under age 18)
Hold Harmless Release:
Date:
This release bars your rights to recover damages in the case of an accident injuring you. READ BEFORE SIGNING!
In applying to East Coast Surfing Championships Skim boarding Championships(CE ECSC), I promise to inspect the contest site, and assure myself that the
area is safe for skimming and further agree that I will not skim in the contest unless I am satisfied that the area and conditions are safe for skimming
purposes. In exchange for CE ECSC accepting my entry form, I voluntarily agree to assume all risks incident to the sport of skimming. With full knowledge,
comprehension, and understand of these responsibilities, I voluntarily accept and assume all risks involved in competitive skimboarding. I will further read
and comply with all CE ECSC rules and regulations, and do agree that noting existing weather conditions, that I voluntary assume all risks arising from
conditions related to use of the contest site by myself and others. I give CE ECSC permission to arrange to telecast, show, or print and publish and/or all
audio and/or pictures taken of me (movie, video, or still) in conjunction with said event. In consideration of our acceptance of my entry, I intend to be
legally bound, hereby for myself, my heirs, executors and administrators, hold harmless and release and forever discharge CE ECSC, the City of Virginia
Beach, the State of Virginia and the Virginia Beach Jaycees, Inc., Glaspro, Inc. and their sponsors, members, agents, and any officials connected with his
competition, from all liabilities for injuries and damages whatsoever, arising from my presence and/or participation in the above described event and do
hereby grant the sponsors such releases as described herein. I acknowledge that I have read and understand all of the above.