Location: Midland, MI 48642 |
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Boat captains we need you to sign up for this years Walleyes for Warriors as soon as you can so we can get going on signing up the Vets. Don't want to get the horse in front of the cart. Please remember to sign the Boat Captains App along with the Liability Release Form. If you know of anyone or business that would be interested in being a sponsor please let me know or have them contact me. Thanks Group. Nels Larsen www.walleyesforwarriors.com
2012 Boaters / Liability Release
2012 Walleyes For Warriors Boat Captain Sign-up Sheet
Each line below must be filled out. This event is on Father’s Day weekend, June 16th & 17th at Veteran’s Park in Bay City. Boat Captains MUST attend the Captain’s Meeting on Saturday, June 16th beginning at 2:00 p.m. to sign in and get instructions for the next day’s event. You will also attend the Meet and Greet Event Saturday afternoon to meet the Veterans you will be taking out on Sunday. Other events will also be occurring Saturday, so plan to be there a few hours. Attendance on Saturday will help us avoid several organizational problems as we are loading Veterans onto your boats early Sunday morning. In case of emergency and your inability to attend, please FIRST call (989)837-2681. If you get no answer, SECOND call (989)928-4368. We can then assign your Veterans to another boat. After you have finished filling this out, either e-mail it to [email protected] or mail it to WFW 4202 Flajole Rd., Midland, MI 48642.
1. Last name __________________________________________________
2. First name______________________________________________ ____
3. Full Address___________________________________________ ______
4. Telephone (best to contact you) ________________________________
5. Email Address___________________________________________ _____
6. Boat Handle (if you have one)____________________________________
7. Boat Brand_____________________________________________ _____
8. Boat Size______________________________________________ ______
9. # of Vets you are comfortable taking out in your boat_______________
If you plan to e-mail your application, Copy the application and Paste it in a Word or Notebook Document. Fill it out completely, then email the file to the address listed above.
We will sign up about 80 – 90 Boaters this year.
Walleyes for Warriors - Waiver of Liability
In consideration for being allowed to participate in any activity associated with the event, including an activity involving fishing from a boat on a lake (“Fishing Activity”), which I do freely and voluntarily undertake for my own personal benefit, I hereby, for myself, my executors, administrators, heirs, next of kin, successors and assigns:
A. Waive, release and discharge from any and all liability Brain Injury Association of Michigan (“BIAM”) and the Michigan Chapter of the Paralyzed Veterans of America (“MPVA”), the Saginaw Chippewa Indian Tribe, the Soaring Eagle Casino & Resort, the event volunteer boat captains, and their respective, directors, officers, employees, agents, vendors, sponsors and volunteers for any bodily injury, death, disability, personal injury, property damage, or property theft, or actions of any kind which may hereafter accrue to me or to any property owned by me from my participation in the Fishing Activity.
B. Agree to indemnify and hold harmless BIAM and MPVA and their respective directors, officers, employees, agents, vendors, sponsors and volunteers (the preceding persons are individually referred to as an “Indemnified Party”), from any and all liabilities, losses, expenses (including attorney fees, disbursements of counsel, court costs and costs and fees on appeal), damages, costs and/or judgments paid or incurred by any Indemnified Party in connection with or arising out of my participation in the Fishing Activity, including any amounts paid or incurred as a result of any demand, claim, suit or proceeding which is brought, made or filed by any person or entity that relates to my participation in the Fishing Activity.
I know that there may be risks associated with the Fishing Activity and willingly accept those possibilities. I know that it is my responsibility to ensure my own safety. I take full responsibility for my own health and safety in participating in the Fishing Activity and to the extent I deem advisable, will consult a physician before participating in any of the activities. I agree to follow all safety practices recommended for safe participation in a boat, and rules established by BIAMI, the MPVA, and the event directors, for participation in the Fishing Activity and to also comply will all commands of any person who has authority over the boat from which I fish.
Therefore, intending to be bound and as a condition of being allowed to participate in the Fishing Activity, I have freely signed this waiver at the time of registration.
All boaters and Veterans much sign and send to Nels Larsen. [email protected] or 4202 Flajole Midland, MI 48642
Print Participant Name: __________________________________________________ _
Participant Signature: _________________________________ Date: ______________
Date of Birth: _______________
If the participant is under 18 years of age, a parent or guardian must sign below on behalf of the participant.
Print Parent/Guardian Name: ______________________________________________
Signature of
Parent or Guardian: ___________________________________ Date: _______
__________________
www.walleyesforwarriors.com
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NEED BOAT CAPTAINS TO SIGH UP ASAP 2012 WFW