2006 U.S. Senior NATIONAL BADMINTON CHAMPIONSHIPS

June 28 - July 2, 2006

Westborough, Masschusetts

Westborough High School, 90 West Main Street, Westborough, MA

Massachusetts Badminton Association

Sanctioned by USA Badminton


ENTRY FORM 2006 U.S. SENIOR NATIONAL BADMINTON CHAMPIONSHIPS
Entry Deadline: June 1st, 2006

First Name: Last Name: USAB#:
Address:
City: State: ZIP:
Telephone:(day) (cell)
Birthdate: (mm/dd/yyyy) Sex: Male Female
E-Mail: (mandatory for electronic confirmation)

ENTRY INFORMATION - My signature on this form certifies that I have read and understood the application. Please enter me in the following events:
MS WS MD WD XD DOUBLES PARTNER MIXED PARTNER
.. use REQ to .. .. request a partner ..
Junior Senior (35+)
Senior I (40+)
Senior II (45+)
Master I (50+)
Master II (55+)
Grand Master I (60+)
Grand Master II (65+)
Golden Master I (70+)
Golden Master II (75+)
Platinum (80+)

Number of Events: x $25.00 + $5 = $ First Event $30, additional event $25
Banquet Tickets: x $25.00 = $
Polo Shirt Upgrade x $7.50 = $
USAB Membership x $30 = $
+ ____.__
Total Fees enclosed: $
Make checks payable to: Massachusetts Badminton Association
Mail to:
Beth Sopka
28 Bradford Street
Boston, MA 02118.

Note: No refunds after June 10th, 2006.

--> Any additional comments/suggestions you wish to make can be entered here:


RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT

1. IN CONSIDERATION of being permitted to participate in any way in USA Badminton sanctioned events, I or my personal representatives, assigned heirs, and next of kin:

2. ACKNOWLEDGE, agree and represent that I understand the nature of badminton activities and that I am qualified in good health and in proper physical condition to participate in such activity. I further agree that if at any time I believe conditions or equipment to be unsafe, I will immediately discontinue further participation in the activity.

3. FULLY UNDERSTAND that: (a) BADMINTON ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH ("RISKS"); (b) these Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the activity. the condition in which the activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW: (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation in the activity.

4. HEREBY ACCEPT AND ASSUME ALL SUCH RISKS, KNOWN AND UNKNOWN, AND ASSUME ALL RESPONSIBILITY FOR THE LOSSES, COSTS, AND/OR DAMAGES FOLLOWING SUCH INJURY, DISABILITY, PARALYSIS, OR DEATH, EVEN IF CAUSED IN WHOLE OR IN PART, BY THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW:

5. HEREBY RELEASE, DISCHARGE, AND AGREE NOT TO SUE THE USA BADMINTON, MASSACHUSETTS BADMINTON ASSOCIATION, MAUGUS CLUB OF WELLESLEY, MA, GUT 'N FEATHERS CLUB OF MARBLEHEAD, MA AND WESTBOROUGH PUBLIC SCHOOLS, WESTBOROUGH, MA, VOLUNTEERS AND EMPLOYEES, OTHER PARTICIPANTS, ANY SPONSORS, ADVERTISERS, AND, IF APPLICABLE, OWNERS AND LESSORS OF PREMISES ON WHICH THE ACTIVITY TAKES PLACE (each considered one of the "RELEASEES" herein), FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES", OR OTHERWISE INCLUDING NEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I, or anyone on my behalf, makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim.

6. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT,

Signature of Participant:

Date:


WWW: or this form.

teuben@astro.umd.edu (last modified: May, 11, 2006 )