31^st ANNUAL NYSMA TRAP & SKEET TOURNAMENT

AUGUST 2^nd, 2008 at the BIG TREE SPORTSMAN'S CLUB

5702 WALTONIAN ROAD, ASHVILLE, NY

HOST LODGE: LAKEWOOD #2587

52 DUNHUM AVE, CELORON, NY (716) 664-7606

 

 

NAME: __________________________________________(AGE, IF JUNIOR_______)

 

ADDRESS:_______________________________________PHONE:_______________

 

CITY:___________________________________________STATE:_____ZIP:________

 

SHOOTING FOR LODGE (NAME & #):______________________________________

EVENT (CIRCLE ONE):      TRAP           SKEET           BOTH

 

COST: $18 PER EVENT OR $32 FOR BOTH.......JR. SHOOTER $12/EVENT

Please send completed application along with payment (make checks payable to New York State Moose Association) to: DENNIS McGINN, 3942 EAST RIVER ROAD, GRAND ISLAND, NY 14072, by Midnight July 31^st, 2008. For more information call Dennis McGinn at (716) 773-3505 between 11:30am-6:00pm weekdays or anytime on the weekends. Walk-ins are welcome!

 

In consideration of the acceptance of my application to enter this Trap and Skeet Tournament, I hereby waive, release and discharge any and all claims for damages, death, personal injury or property damage, which I may have or which may subsequently occur to me as a result of my participation in this event. This release is intended to discharge MOOSE INTERNATIONAL INCORPORATED, any State or provincial Moose Association and/or any sponsoring lodge/s, their respective agent/s and employee/s from and against any and all liability arising out of or connected in any way with my participation in this event, even though liability my arise out of negligence or carelessness on the part of the person/s or entity mentioned above. The terms hereof shall serve as a release and assumption of risk for my heirs, executors, successors, administrators and assigns in exchange for my participation in this event. I, the undersigned, acknowledge that I am 21 years of age or older*, and under no physical disability that would prohibit my involvement in this tournament. I, the undersigned, attest and affirm that I have read the rules of this event and agree to abide by said rules. I also affirm that the statements set forth above are true and correct. I have read and agree to the conditions stated above.

 

_________________________________________ ______________________

Participant's Signature *                                                                           Date

*(or parent/guardian for Jr. Shooter)