Shot gun start: 5:00 PM All players must sign waiver before start of tournament. Payment must be received by The Big
House in order for the team to be registered. Please mail payment to The Big House Foundation PO Box 4291 Macon GA
31208. If you need an invoice, please let us know. If you would prefer to pay with a credit card, please call 478-741-5551
ext 1
Team name:______________________________________________________________________________
Contact email:____________________________________________________________________________
Contact phone:___________________________________________________________________________
Player #1
Name:__________________________________________________________________________________
Handicap:_________ email:_______________________________________________________________
Player #2
Name:__________________________________________________________________________________
Handicap:_________ email:_______________________________________________________________
Player #3
Name:__________________________________________________________________________________
Handicap:_________ email:_______________________________________________________________
Player #4
Name:__________________________________________________________________________________
Handicap:_________ email:_______________________________________________________________
Internal use only:
Form of payment
Waivers received
comments
WAIVER AND RELEASE
In consideration for being permitted to use the facilities and property of Healy Point Golf & Country Club
(the “Facilities”) during The Big House Museum night-golf event (the “Event”) and my participation in
the Event, I agree as follows:
I understand the Event is a golfing event that takes place in the evening and night, and I acknowledge
there are inherent risks associated with participating in the Event that may be greater than participating
in a normal golfing tournament or event. I agree to forever release Sequoia Golf Healy Point LLC,
Sequoia Golf LLC, each of their parent, subsidiary, and affiliated entities, and each and all of their
officers, boards, members, employees, agents, volunteers, and contract employees (collectively
“Sequoia Golf”) from any and all liability, claims, rights of action and causes of action that may have
arisen or may arise, directly or indirectly, from property damage, personal injuries, or otherwise to
myself resulting from my participation in the Event.
In signing this document, I intend to bind my successors and assigns or anyone acting on my behalf, and
further shall save and hold harmless Sequoia Golf and all related parties named above.
I have read and understand the foregoing Waiver and Release, and sign it voluntarily.
_____________________________
Name (Print)
_____________________________
(Signature)
__________________
Date