Registration Form

    Participant Information

    Medical Release:

    ​I fully realize that injury may result from or during participation in this class.  In case of injury, I give permission to be given medical treatment as deemed appropriate.  I further give permission for the information provided on this form to be shared with appropriate medical personnel.  I further give permission for and grant authority to Mariners Point representatives to sign on my behalf the Notice of Privacy Practice that patients are required to receive in accordance with federal law.  I understand and acknowledge that I will be responsible for any medical bills incurred.
    LIABILITY WAIVER:  I acknowledge and assume all the foregoing risks and likewise accept personal responsibility for any injury or damages that may occur.  I release, waive, discharge and covenant not to sue Mariners Point VBGolf LLC administrators, agents, sponsors, other participants, advertisers, and owners/lessors of premises used to conduct the activities.  I have read the above waiver and release, and understand that I have given up substantial rights by signing it, and sign it voluntarily.