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7th Annual Great Southern Beach Shootout
April
3rd, 4th&; 5th, 2009 |
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REGISTRATION FORM
Use one entry per person (copy if necessary). |
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FEES: The cost to enter the GREAT SOUTHERN BEACH SHOOTOUT is $200.00 per person, which covers all hunts. Payment in full must be sent with Registration Form. Registration Form must be filled out COMPLETELY. HUNTS WILL BE HELD RAIN OR SHINE. NO REFUNDS. |
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Please Print Clearly in Ink or Type |
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Name_________________________________________________ Phone_________________________ |
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Address______________________________________________________________________________ |
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City / State / Zip_______________________________________________________________________ |
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E-mail Address________________________________________________________________________ |
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$200.00 per person -Check or Money Order - Amount Enclosed: $________________________ |
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FREE KIDS HUNT |
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Name(s) and age(s) of Child(ren)
________________________________________________________ |
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No credit cards will be accepted. There will be a $25.00 returned check fee. |
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CHECKS MUST BE RECEIVED BY
Friday March 20
, 2009
AFTER THAT, ONLY CASH OR MONEY ORDERS WILL BE ACCEPTED AT THE REGISTRATION DESK! |
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I acknowledge by my signature below, that I release the Great Southern Beach
Shootout (GSBS) staff, organizers and individuals, all
sponsors, The Plaza Resort & Spa, Volusia
County and the City of Daytona Beach from any claims whatsoever, including,
but not limited to, loss, accidents, fire, theft or personal injury. I agree
that the GSBS may make any changes they deem necessary for the betterment of
the event, Decisions of the GSBS organizers are final. I also hereby give
permission to use my name and/or photographic likeness in all forms,
including but not limited to print, broadcast, videotape, CD-ROM,
electronic/online media, and any other lawful purposes. The GSBS reserves
the right to refuse registration at their discretion. I understand that it
is against the law to have open containers of alcohol on the beach.
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Signature__________________________________________________ Date________________________ |
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Note: If you do not sign the release, you will not be allowed to participate in
THE GREAT SOUTHERN BEACH SHOOTOUT. |
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Check/money order should be made PAYABLE TO:
Mail Check/Money Order
& Registration Form to: |
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BELLE PEYTON
242 Tarragona Way
Daytona Beach, FL32114 |
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For more information,visitNEW website, www.gsbsdaytonahunt.com or contact: |
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Deyton Peyton
peyton@gsbsdaytonahunt.com
386-255-4659 |
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-or- |
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Ray Leist
huntmaster@gsbsdaytonahunt.com
386-428-3401 |
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SEE YOU AT THE GREAT SOUTHERN BEACH SHOOTOUT! |
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