National Goalie War Association, Tournament Hosting Application

> 2008 Natl Goalie War Championship Registration Form

Complete this application and submit online or mail/fax with payment to:

       The National Goalie War Association
       P.O. Box 105
       Shrewsbury, PA 17361
       OR Fax to:
       (717) 235-3299


Player Name
Parent's Name
Gender	Male Female
Date of birth
NGWA Member	Yes No
Address
City
State
Zip Code
Home Phone Number
Cell Phone Number
Email address
T-Shirt Size: Small Medium Large XLarge XXLarge


How did you hear about this tournament	Invitation Mailer Friend or Family Coach Internet Other

Registration Fee	$150.00 ($130.00 for NGWA members)

Registration Deadline	October 24, 2008

Payment	Check Please mail check to the NGWA, P.O. Box 105, Shrewsbury, PA 17361 Credit Card Please call the NGWA at 1-717-659-3344 with credit card information or print/fax form with card number, expiration date and security code to 717-235-3299

Waiver and Medical Release Form:
By submitting this registration form, I understand and agree that there are risks connected with my participation or my child's participation in this tournament and its related activities. I release, waive and discharge and covenant not to sue the NGWA, event hosts, sponsors, event charities and their workers, employees and directors, from all claims, actions, suits and demands whatsoever in law or in equity from demand, losses or damages on account of injury including death caused in whole or in part by the negligence of the releasee or otherwise. In case I cannot be reached during an emergency, I give permission for my child to be treated by a licensed physician, and for said physician to administer whatever care is necessary for his/her safety and care. Furthermore, I hereby irrevocably release, consent to and authorize the National Goalie War Association, event sponsors and organizers the right and full permission to: 1) record any or all images, no matter by who taken, of my participation in this event for photos, motion pictures, TV, radio, recordings, videotapes, and other media known or unknown and 2) copyright, use, produce, publish, publicly distribute and reproduce those images in any manner for the purpose of advertising and/or promoting the services and contests of the NGWA and its members, event hosts, sponsors, organizers and affiliates, without any compensation of any kind due to me or anyone else. I understand and agree that a player’s eligibility for NCAA, collegiate sports and/or local school districts vary and that the NGWA is not responsible for determining my eligibility. Furthermore, the NGWA, event hosts, sponsors and/or organizers are not responsible in any way should I become ineligible to participate in any sport due to my participation in this tournament.

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