Boynton Golf League -2010     Registration Form

GENERAL RELEASE

On behalf of the above, I, the undersigned participant/parent/guardian, in consideration for the Boynton Golf League providing coordinated services in the activity for which I/he/she has registered, do hereby (1) Assume all risks and responsibility of possible damage or injury involved through participation in said activity.  I understand I am to furnish my own insurance in case of injury; (2) Request permission to participate in the activity with full knowledge that said activity could result in damage or injury to me/him/her.  (3) Agree to indemnify & hold harmless the City of Boynton Beach and/or its departments or agents from liability resulting from my/his/her participation of said activity; (4) Give the Boynton Beach Golf League permission to take photos and use them to publicize programs and use in media correspondence.

 

Print Name:
 

Date:

Signature:
 

E-Mail Address:
* * *

Playing Partner:
 

Home Phone Number:
* * *

Alternate 1:

Work Phone Number:
* * *

Alternate 2:
 

Cellular Phone Number:
* * *

* * * Please include any/all phone numbers and an email address (if one exists).  The phone numbers and email address should be used to contact your weekly opponents to schedule your round with the other team.  The email address will also be used for providing weekly status updates, scores, team standings and general information.