MEMBERSHIP $55

Player Name: Age: Phone:  Sex: Male Female

Address: City: Zip:  

State: AL AK AZ AR CA CANADA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY    E-mail Address: Birthdate: MM/DD/YY

Date Joined: MM/DD/YY

RELEASE
Required for participation

I / We , as the parent(s) or legal guardian(s)of the minor child named above, agree to abide by and uphold the Guidelines of the FSJGT and to unconditionally release and hold harmless and not to bring any suit or legal action to bear on the FSJGT, its staff, volunteers, sponsors, affiliates or successors and assigns as a result of any accident or injury to the minor child arising from participation in any FSJGT event. I / we also give permission to allow the use of photographic images of my child by the FSJGT for Tour promotional purposes.

By entering your name in the above parent(s) or legal guardian(s) you have signed an electronic document an agree to the terms and conditions outlined above.