Tuesday,July4th,2017
11:00a.m.– 4:00p.m.(TennisCourts)
TEAMSMUSTARRIVEAT10:00a.m.forRegistration
Red,WhiteBlueDivision‐
CornHole‐ TeamName:__________________________________
Tuesday,July4th,2017
11:00a.m.– 4:00p.m.(TennisCourts)
TEAMSMUSTARRIVEAT10:00a.m.forRegistration
Red,WhiteBlueDivision‐
CornHole‐ TeamName:__________________________________
Player#1:________________________________________________________
Player#1:________________________________________________________
Player#1:________________________________________________________
Player#1:________________________________________________________
Player#2:________________________________________________________
Player#2:________________________________________________________
Player#2:________________________________________________________
Player#2:________________________________________________________
(print)
(signature)
(print)
(signature)
ALLPLAYERSMUSTSIGNROSTER
(print)
(signature)
(print)
(signature)
ALLPLAYERSMUSTSIGNROSTER
Insigningthisform,Iherebygivepermissionformyselftoparticipateinthecornhole
tournamentandcertifythatIamphysicallyfittojoinintheactivities.Iwillhold
harmlessandindemnifytheCityofDelphosortheDelphosKiwanisClubincaseof
accident/injuryorlossasaresultofparticipationinthetournament.Iunderstandthat
theCityofDelphosandtheDelphosKiwanisClubdoesNOTcarryhealth/accident
insurancetocoverparticipantsorspectatorsinanyrecreationalprogram.Ialso
understandthatoccasionallyphotosmaybetakenofparticipantsinevents.Igive
permissiontoallowthesephotostobeusedinfuturepromotionalinformation.
Insigningthisform,Iherebygivepermissionformyselftoparticipateinthecornhole
tournamentandcertifythatIamphysicallyfittojoinintheactivities.Iwillhold
harmlessandindemnifytheCityofDelphosortheDelphosKiwanisClubincaseof
accident/injuryorlossasaresultofparticipationinthetournament.Iunderstandthat
theCityofDelphosandtheDelphosKiwanisClubdoesNOTcarryhealth/accident
insurancetocoverparticipantsorspectatorsinanyrecreationalprogram.Ialso
understandthatoccasionallyphotosmaybetakenofparticipantsinevents.Igive
permissiontoallowthesephotostobeusedinfuturepromotionalinformation.
RegistrationFee:$50perteam:
Rosterandfeesdueby10:00AMJuly4th,2017
Checkspayableto:DelphosKiwanisClub
ScottWiltsie,902MetblissAve,Delphos,OH45833
(p)419‐692‐2067(e)[email protected]
RegistrationFee:$50perteam:
Rosterandfeesdueby10:00AMJuly4th,2017
Checkspayableto:DelphosKiwanisClub
ScottWiltsie,902MetblissAve,Delphos,OH45833
(p)419‐692‐2067(e)[email protected]