Event: 2011 Season, FBA Contest No. 2
Date of Event: September 17-18, 2011
Location: Canova Beach Park, Indian Harbor Beach, FL

INDEMNITY – In consideration of acceptance of my entry, I intend to be legally bound, do hereby for myself, my heirs and administrators of the FBA, USBA and its affiliates release and forever discharge any and all rights and claims for damages which may hereafter accrue against the competition, it’s officials, employees, government agencies and contest sponsors, of any and all liability and responsibility arising from any injury received or incurred by participating in this event. I will inspect the contest area and assure myself that the area is safe for bodyboarding and further agree that the area conditions are safe for bodyboarding purposes. Further I acknowledge that I voluntarily assume all risks arising from the conditions relating to the use of the contest site and surfing area by myself or others. I will comply with the USBA/IBA rules and any rules announced at the event. I agree to the release of all official photographs and video footage taken during this event and its use by the contest director and sponsors.

CONDUCT – I agree that I will behave myself appropriately at all times over the event and activities surrounding the event, I will abide by the FBA & USBA rules for competitors at events and understand that my failure to do so may result in penalties. By signing you state that you have read the above and that all information provided is true and correct.

Parent Signature is Required If under 18 years of age. A print out of the form with the hand signature of the parent will have to be provided at the contest.

A $10 late fee will be charged after the comencement of the event.

You can opt to mail your payments to:

FBA – Al Rumbos
3607 W Bay Ave
Tampa, FL 33611

Entry Forms need to be filled out and submitted, and fees paid one week before the event to avoid any late fees.

For more information and current updates, check www.fbatour.com , contact Al Rumbos at (813) 404-8734 or email us at info@fbatour.com

Fill out the following information:

1. First Name(required)
2. Last Name(required)
3. Date of Birth(required)
4. Email(email required)
5. Phone Number(required)
6. Street Address(required)
7. City(required)
8. State/Province -Please select one- Outside US & Canada AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WI (required)
9. ZIP/Postal Code(required)
10. Country -Please select one- Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Cyprus, Republic of Cyprus, Turkish Republic of Northern Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia, The Gaza Strip Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jericho Area Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar (Burma) Namibia Nauru Nepal Netherlands, The Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Réunion Romania Russia Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines San Marino São Tomé and Príncipe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia & the South Sandwich Islands Spain Sri Lanka Sudan, The Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Vietnam Virgin Islands (British) Virgin Islands (U.S.) Wallis And Futuna West Bank Western Sahara Western Samoa Yemen Yugoslavia Zaire Zambia Zimbabwe OTHER (required)
11. T-Shirt Size -Please select size- XS S M L XL (required)
12. Category
13. PRO $50 AM $25 DK $25 STAND UP $25 JUNIOR (18 & under) $25 WOMEN $25
14. 1. I understand that I am over 18 years of age or I'm the legal guardian of the contestant. I also understand that by typing my name bellow will be my official signature and that I also agree to the terms above
15. I agree
16. Sign Your First and Last Name(required)