As parent or legal guardian of the above applicant, I hereby certify the facts stated on this entry form as true and accurate to the best of my knowledge and that I am aware of his/her plans to participate in the GCJGF December 11, 2005 tournament at Palm-Aire Country Club and that he/she does so with my permission. Further, I, for the applicant and myself, hereby release GCJGF, its Directors, Officers, Members, Employees, Volunteers, and host courses from any and all liability for any events or consequences whatsoever in any way arising out of or relating to the applicant’s participation in this tournament with the sole and singular exception of liability arising out of bad faith or willful misconduct. The GCJGF reserves the right to use any picture(s) taken of the above applicant as part of the GCJGF program and I grant permission for the picture(s) to be used without restriction, fee, or royalty. I understand the rules regarding entry and withdrawal as set forth in the handbook and agree to abide by them.
In case of a medical emergency occurring during these championships, I authorize all necessary measures in the treatment of this applicant.

I confirm my electronic signature by submitting this form.