Child's First & Last Name

Grandparent's Name

Phone *

$20 Registration Fee *

$ 20

Email *

I consent to receive SMS Notifications and alerts from Brantley County Recreation Department.

As parent/guardian of the above-named child, I hereby certify that said child has my permission to attend and participate in above mentioned tournament. I understand that the above mentioned Grandparent must supervise the child at all times. In signing this form, I hereby waive and release all other participants, hosts, sponsors, judges, and all other officials or parties involved with the tournament from all claims, injury, and/or damage incurred in connection with this fishing tournament. I also hereby grant the host and sponsors the right to use the name, voice, and photographic likeness of the said child in connection with any of the articles, press releases, and audio/video productions. *Please enter your full name to sign*

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