RELEASE FORM


Club Activity: _Holmdel_Golf_League_________________________________________

Name: ______________________________________________________________________

Email: _____________________________________________________________________

Home Addr: _________________________________________________________________

Home Phone: ________________________________________________________________


In consideration of my being permitted to participate* in the above mentioned 
activity, I, for myself, my heirs, legal representatives, and assigns, do 
hereby release said activity, and the Holmdel Golf League, its organizers, 
sponsors, members, and participants, from all suits, claims or demands of any 
kind, which may result from my death, injury, loss or damage of any kind, 
occasioned by my participation in said activity.

I hereby warrant that I am of full age and free to give this release which I 
have read and understand.**

Signed _______________________________________________  Date _______________

Witnessed by   _______________________________________  Date _______________

** If the above person is not 18 years of age or over, the statement of age 
should be stricken out, and the parent or guardian should sign below.

Signed _______________________________________________  Date _______________

Witnessed by   _______________________________________  Date _______________

* Refusal to sign this release disqualifies the applicant from authorized 
participation in the activity.

FORWARD THIS SIGNED AND COMPLETED FORM TO YOUR FLIGHT SECRETARY.