Zap Gulf Coast Pro/Am Spring Skim Jam

Date:          April 17 & 18

Location:  SHARKY’s Beach Club Restaurant & Tiki Bar

                   (Towne of SEAHAVEN)                                 

                   15201 Front Beach Road   Panama City Beach, Florida      

Cost:           $25 for Amateur Divisions                  $85 for Pro Division    

($15 separate SKIM EAST membership fee (must be active 2010 Skim USA member)

Total:          $40 Amateur Division                         $90 Pro Division

Add $50 for Semi-Pro Division

 

DEADLINE- April 15H -ABSOLUTELY NO LATE ENTRIES & NO BEACH ENTRIES

Make Check Payable to:  SKIM U.S.A. NGFL District

Send Entry to:  7220 Thomas Drive, Panama City Bch FL 32408

                            

T-shirt size (circle one):   xs(BoysL)   S      M       L      XL     XXL

 

Note competing in both Amateur & Semi Pro is allowed & encouraged

ENTER AGE Division based on age you”ll be 8/27/10                        

Please fill out completely and legibly

____ Minis (8 & under)               ____ Men (18-21)             _____ Women (15-77)
____Sr Grandmasters (40 & up)
____Menehunes (9-11)                ____ Sr Mens (22-24)            _____Girls (1-14)
____Boys (12-14)                    ____ Masters (25-29)            _____New Division SEMI PRO
____Juniors (15-17)                    ____ Grandmasters (30-39)            _____Professional
Sponsors______________________________________________________________________
Name:__________________________________________Home Phone:___________________ Work Phone:___________________
Street:_________________________________________________City:___________________State_________Zip________
Age:_________________________
Date of Birth:___________________Email:___________________________________________

Hold Harmless Release: This release bars your rights to recover damages in the case of an accident injuring you. READ BEFORE SIGNING! In applying to the Skim USA tournaments, 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 ands conditions are safe for skimming purposes. In exchange for Skim USA accepting my entry form, I voluntarily agree to assume all risks incident to the sport of skimming. With full knowledge, comprehension, and understanding of these responsibilities, I voluntarily accept and assume all risks involved in the spirit of competitive skim boarding. I will further read and comply with all Skim USA rules and regulations, and do agree that, noting existing weather conditions related to use of the contest site by myself and others I give Skim USA permission to arrange to telecast, show, or print and publish any/or all audio and /or pictures taken of me (movie, video, or still) in conjunction with said event. In consideration of your 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 Skim USA, the city/town of Panama City Beach, the county of Bay, the State of Florida, and sponsors Panhandle Surf Inc. (Mr. Surf’s Shop), Sharky’s, Towne of Seahaven, and Glaspro Inc., their members, agents, and any officials connected with this 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.
Contestant’s signature ___________________________________________Date___/___/___
                                                                                                                                                                               
FOR CONTESTANTS UNDER 18 YEARS OF AGE: I HEREBY CERTIFY that I am the 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 Skim USA Officials, Judges, and Directors to properly supervise contestants in the course of competition.
Signature of Parent/Guardian ___________________________________Date___/___/___

 

EVENT INFORMATION:

Mr. Surf’s Surf Shop 7220 Thomas Drive - (850)235-2702 or website: www.mrsurfs.com

Panama City Beaches Chamber of Commerce:  850-234-3193   www.pcbeach.org

Panama City Beach Convention and Visitors Bureau: 800-PC-BEACH  www.800pcbeach.com

Reservations at Contest Site: www.towneofseahaven.com or 800-908-0006 /850-636-8550

contact: reneereyer@towneofseahaven.com

Hotels: (Seahaven Beach Hotel Inn or America’s Best Value Inn) www.pcbeachescapes.com

800-874-7101 or 850-234-6636 suzy@pcbeachescapes.com