Waiver and Release Form

Additional information, brochures and/or entry forms and waiver release forms can be obtained by calling:

Arkansas Hospitality Association
501-376-2323

WAIVER AND RELEASE
You must read and agree to this waiver and release by checking the box and entering your name. If mailing, you must print and sign the form.

Arkansas Hospitality Association
P.O. Box 3866
Little Rock, Arkansas 72203
501-376-6517

Instructions

1. All applicants must complete Part A of the form below. In addition, applicants under the age of 18 MUST print a copy of the form and fax/mail a signed copy, including the signature of a parent/guardian. (Download a PDF Version)

2. You must provide your Social Security Number to complete your registration. The Social Security Number is necessary in order to issue cash prizes.

Part A: Waiver and Release from Liability

In consideration of being permitted to enter for any purpose any RESTRICTED AREA (herein defined as the areas to which admission by the general public or spectators is prohibited), or being permitted to compete, officiate, observe, work for, or any purpose participate in any way in the event, EACH OF THE UNDERSIGNED, hereinafter referred to as “releasor,” for himself, his personal representatives, heirs, next of kin, acknowledges, agrees, and represents that he has, or will immediately upon entering any such restricted areas, and will continuously thereafter, inspect such restricted area or areas and all portions thereof which he enters and with which he comes in contact, and he does further warrant that his entry upon such restricted area or areas and his participation,if any, in the event constitutes an acknowledgement that he has inspected such areas and that he finds and accepts the same as being safe and reasonably suited for the purpose of his use, and he further agrees and warrants that if, at any time, he is in or about restricted areas and he feels anything to be unsafe, he will immediately advise the officials of such and will leave the restricted area(s) and further:

1. HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the “Arkansas Big Bass Bonanza,” the promoters, other participants, operators, officials,any persons in a restricted area, sponsors, advertisers, owners and lessees of premises used to conduct the event and each of them, their officers and employees, all for the purposes hereinafter referred to as “releasee,” from all the undersigned, his personal representatives, assigns, heirs, and next of kin for any and all damage, and any claim or demands therefore on account of injury to the person or property of resulting in death of the undersigned, whether caused by the negligence of the “releasee” or otherwise while the undersigned is in or upon the restricted area, and/or, competing, officiating in, observing, or working for, or for any other purpose participation in the event.

2. HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the releasees and each of them from any loss, liability, damage, or cost they may incur due to the presence of the undersigned in or upon the restricted area or in any way competing, officiating, or working for, or for any purpose participating in the event and whether caused by the negligence of the releasees or otherwise.

3. HEREBY ASSUMES FULL RESPONSIBILITY FOR ANY RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE due to the negligence of releasees or otherwise while in or upon the restricted area and/or while competing, officiating, observing, or working for, or for any purpose participating in the event.

4. EACH OF THE UNDERSIGNED expressly acknowledges and agrees that the activities at the event and in the restricted areas are dangerous and involved the risk of serious injury and/or death and/or property damage. EACH OF THE UNDERSIGNED further expressly agrees that the foregoing release, waiver, and indemnity is intended to be as broad and inclusive as is permitted by the law of the Province or State in which the event is conducted and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full force and effect.

THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations, statements, or inducement apart from the foregoing written agreement have been made. This waiver, release and indemnification agreement specifically embraces each and every event sanctioned, authorized or promoted by said releasees during the entire season and applies to each and every activity or event in which the undersigned participates so that the parties herein intended to be released and indemnified shall be fully and effectively released and indemnified as to each and every event herein above described.

Print Name__________________________________________________

Social Security Number (Optional, however we cannot issue a check to you over $600 without your Social Security Number)_______________

Part B: Parent/Guardian Waiver-Release from Liability

If applicant is under 18 years of age, the parent(s) or guardian(s) must execute, in addition to the above, this following waiver.

The undersigned ________________________________ referred to as the parent(s) and natural guardian(s) of _______________________________ does hereby represent that he/she (they) is (are) in fact, acting in such capacity and agree to save and hold harmless and indemnify each and all of the parties herein referred to above as releasees from all liability loss, cost, claim or damage whatsoever may be imposed upon said releasees on behalf of both of the undersigned.

Name _______________________________________________________

Relation to Minor ____________________

Name_______________________________________________________

Relation to Minor ____________________

If applicant is under 18 this form must be filled out prior to online registration and faxed or mailed to:

Arkansas Hospitality Association
P.O. Box 3866
Little Rock, Arkansas 72203
501-376-6517