Platte Valley Archers, Inc. 2017 Registration Form
Email address
Last Name
Your answer
First Name
Your answer
Address:
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City:
Your answer
State:
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Zip:
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Phone:
Your answer
Club:
Your answer
Sex:
Bow:
Sights:
Release:
Arrow:
Age (for target, NFAA rules apply)
Select an event
City of Columbus Visitor Bureau Survey
Please complete only if you are personally paying for a motel room or rooms.
Number of People Staying in Hotel
Waiver
Please Read and Complete the Waiver
In consideration of being allowed to participate in any way in PLATTE VALLEY ARCHERS, INC events and activities, the undersigned acknowledges, appreciates, and agrees that: 1)The risk of injury from archery and other known and unknown events and activities and/ or use of the related buildings, structures, equipment, automobiles, firearms, weapons, ATV's, boats, tree stands, roads, bodies of water, land and all other related and personal property whether owned by archery club or others is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce may reduce this risk, the risk of serious injury does exist; and, 2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or other, 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 for 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 representation and next of kin, HEREBY RELEASE AND HOLD HARMLESS PLATTE VALLEY ARCHERS, INC its officers, directors, officials, agents, employees, volunteers, members, guests, other participate, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of real property and personal property used to conduct the events and activities ("RELEASEES"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person property, WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WETHER ARISING FORM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, TO THE FULLEST EXTENT PERMITTED BY LAW.
Required
FOR PARTICIPANTS OF MINOR AGE (UNDER AGE 18 AT THE TIME OF PARTICIPATION)
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 all 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 minor child's involvement or participation in these events and activities and/or the use of related real and personal as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE.
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To cancel your registration please contact us at pvashoot@gmail.com
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