Name of Father/Father-Figure:

Mailing Address (Father):

Street:

City/State/Zip:

Emergency Contact Person:

Phone:

ALL PARTICIPANTS MUST FILL OUT APPLICATION AND SIGN WAIVER TO PARTICIPATE IN GOLF TOURNAMENT

WAIVER

In consideration of being permitted to participate in “The 2nd Annual Father-Child Golf Tournament & Family Day”, I, for myself , my children and/or juniors, personal representatives or assigns, do hereby release, waive discharge and covenant not to sue the organizations, it’s officers, employees and agents, Maggie Hathaway Golf Course, and the City & County of Los Angeles from liability from any claims including negligence of the organizations its officers, employees and agents, resulting in personal injury accidents or illness (including death), and property loss arising from, but not limited to, participation in the 2nd Annual Father-Child Golf Tournament from the beginning to the close of the event.

Typed Name & Date of all participants will be acknowledged as a signature