GRANDMASTER SUSAN POLGAR
WORLD RECORD CHESS CHALLENGE
REGISTRATION FORM
MAIL CHECK FOR
$7 TO:
NAME ______________________________________
PHONE #
ADDRESS ______________________________________ E-MAIL
______________________________________ T-SHIRT SIZE
USCF RATING, IF
ANY
WAIVER FORM
In
consideration of being allowed to participate in any way in
the Grandmaster Susan Polgar World Record Chess Challenge I, the
undersigned acknowledge, appreciate, and agree that:
1. In
the event of injuries from the activities involved in this program,
2. I
KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown. EVEN IF
ARISING FROM THE NEGLIGENCE OF THE RELEASEES or
others, and assume full responsibility for my participation; and,
3. I,
willingly agree to comply with the stated and customary terms and conditions
for participation. If however I observe any unusual significant hazard
during my presence or participation, I will remove myself from
participation and bring such to the attention of the nearest official
immediately; and,
4. I,
for myself and on behalf of my heirs, assigns, personal representatives and
next of kin, HEREBY RELEASE AND HOLD HARMLESS the US Chess Trust, Channing
Corporation, PGA Commons LLC, the Boca Raton Chess
Club, the Gardens Mall, Forbes Cohen Florida Properties LP, the Forbes Company,
the Gardens Venture, the Gardens Promotion Fund, Inc., the Northern Palm
Beaches Chamber of Commerce, the Palm Beach County Sports Commission and these
organizations’ officers, directors, agents and employees, and the city, county
and state in which this event is taking place, other participants and all
sponsoring agencies, sponsors, advertisers, producers, their agents,
representatives, successors ("Releases"), WITH RESPECT TO ANY AND ALL
INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER
ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR
OTHERWISE.
I
HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY
UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY
SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
PARTICIPANT'S
SIGNATURE____________________________________________ Age: __________
Date signed: _____________________
FOR
PARTICIPANTS OF MINORITY AGE(UNDER AGE 18 AT THE TIME
OF REGISTRATION)
This
is to certify that I, as parent / guardian with legal responsibility for this
participant, do consent and agree to his / her release as provided above of all
the Releasees, and, for myself, my heirs, assigns,
and next of kin. I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor
child's involvement or participation in these programs as provided above.
EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES,
to the fullest extent permitted by law.
____________________________________________
PARENT/GUARDIAN'S SIGNATURE