Page 1. 2014 BARC Competitor Registration Form. Match Dates - July 26-27,
2014. Full Name: Email: Phone: Street Address: City: State: Zip Code: Division ...
2014 BARC Competitor Registration Form Match Dates - July 26-27, 2014 Full Name:
_____________________________________________________________
Email:
_____________________________________________________________
Phone:
________________________________________
Street Address:
_____________________________________________________________
City:
________________________________________
Zip Code:
_______________
Division:
Open
Tactical
Limited
Heavy Metal Limited
Manual _
Heavy Metal Tactical
State:______________
Ope
Class (Highest You Hold): ___________________ (GM, M, A, B, C, D, or Unclassified) USPSA #:
_________________________
Check all of the following categories that apply: Lady
Junior
Senior
Super Senior
Military
LEO
Match Fee:
Match Fee: $130.00 (Match T-Shirt & Hat Included) T-Shirt Size: Sm
Med
Lg
X Lg
XX Lg
XXX Lg _
If you wish to be an RO at the 2014 BARC please check the RO Slot box below and then select which days you wish to RO. Your match fee will be comped and if you RO both days you will be paid $100 for the 2nd day. Dedicated RO shoot day on Friday, July 25th.
RO Slot
Saturday
Sunday
Please make all checks payable to the "Richmond Hotshots" and send your entry to the following address via standard US mail only: BARC 523 Manor Drive Pacifica, CA 94044
Please complete, sign and return this page along with your application: Waiver and Release of Liability READ BEFORE SIGNING In consideration of my participation in any way in the Bay Area Rifle Championship, related events and activities, I,
________________________________________________, Participant Name Here the undersigned acknowledge, appreciate, and agree that: 1. The risk of injury from the activities involved in this program is significant, and while particular rules and personal discipline reduce this risk, the risk of serious injury does exist: and, 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS FOR MYSELF, both known and unknown, Even if arising from the negligence of the releasees or others, and assume full responsibility for my participation: and, 3. I willingly agree to comply with the state and customary terms and conditions for participation. 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release and hold harmless the Richmond Rod & Gun Club, their officers, officials, sponsors, advertisers, event officials and other participants, and if applicable, owners and lessors of premises used to conduct the event ("Releasees"). With respect to any and all injury, disability, death or loss or damage to person or property, whether arising from the negligence of the releasees or otherwise. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
X ______________________________________________________ Date Signed: _______________ Participant's Signature Here
