28th Annual Orange Beach Spearfishing Tournament
  October 4-12, 2024
 Mail to: 4515 5th Avenue South
Birmingham, AL 35222
(205) 595-3052

Application and Release Statement

Name _______________________________________ Telephone ________

Address ______________________________________________________

City ___________________________________ State ____ Zip __________

Team Affiliation _________________________ Date of Birth ____________

*** Email Address_________________________________________________

SCUBA APPLICANTS MUST PROVIDE THE FOLLOWING INFORMATION

Certifying Agency and # __________________________Years Experience _____
 
Registration is $90.00 (ASA Member) #________ $110.00 (Non-ASA Members)

I will be participating in the ____________________ jackpot for an additional $25.00

Shirt Size________

_____  Paid Via PayPal

Total amount enclosed:  $ ___________ Make checks payable to: Ala. Spearfishing Assn.
Please enclose this form and mail with "non refundable" payment to the address at
the top of this page.  Mailed registration must be received no later than the Safety Meeting.

RELEASE STATEMENT
I, ________________________, in consideration of permission granted me to participate
in this Spearfishing Tournament to be held October 4-12, 2024
do hereby agree that I will not hold any official connected with said tournament
responsible for any accident or damage to me or my property which may occur during
said tournament. I have read, fully understand and agree to the rules of this contest.

Done this _____ day of _________________ 2024.

Signed ________________________  Witness _______________________

________________________________________________
Signature of parent or guardian if under 21 years of age.