Read and fill out the required information, enter one event or several at the same time. Make checks payable to "Ice FishingPa" or "IFPA" and mail to :

IFPA

Byron Eckardt

1438 N. River Rd

Halifax PA 17032

You may fill out the form below and mail it to the above address with a check or money order, or you may enter with a credit card through pay-pal at the bottom of the page. You may also enter at the rules meeting (cash or check only) providing openings remain. Payments sent through the mail or processed online by credit card will only be accepted up until the Wednsday prior to the tournament. If we do not receive your payment in time, you will not be entered.

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Check appropriate boxes on left for tournaments and on right for optional big fish pot. Add the total at bottom of page.

------ Beechwood Lake, Tioga PA, Jan 17 2010..................$100.00        -----Big Fish.$20.00

------ Walker Lake, Snyder County PA,  Jan 31  2010........$100.00       ------Big Fish..$20.00

------Silver Lake, Wyoming NY,  Feb 6 2010.......................$100.00       ------Big Fish...$20.00

------Kahle Lake, Clarion County PA,  Feb 14 2010............$100.00      ------Big Fish...$20.00

------Lilly Lake, Luzern County PA, Feb 21 2010................$100.00      -------Big Fish..$20.00

------Bomoseen Lake, Castleton VT, March 6 2010............$100.00      -------Big Fish...$20.00  

----PRO-SERIES. Bomoseen Lake  VT, March 7 2010...$400.00    --------Big Fish ...$20.00

                                                                                              $_____________________$_________= Total $ _________________

Read and sign at bottom of page. If entering as an individual, fill out and sign "Angler One". If entering as a team, both entrants must fill out the required information and both must sign at bottom of page..

Angler One                                                                                     Angler Two

First Name________________________                                      First Name_________________________

Last Name________________________                                       Last Name________________________

Street ___________________________                                        Street ____________________________

City_____________________________                                       City_____________________________

State & Zip________________________                                      State & Zip ______________________

Phone_(_____)_____________________                                      Phone_(_____)____________________

Email_____________________________   

Emergency Contact_____________________                                Email___________________________

In consideration of being allowed to participate in any way in the Ice FishingPA (IFPA) Tournaments, its related events and activities, I, the undersigned, being of at least 18 years of age, acknowledge, appreciate, and agree that:

The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 

I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 

I willingly agree to comply with the stated and customary terms and conditions for participation.  If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Company immediately;  and, 

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY  RELEASE, INDEMNIFY, AND HOLD HARMLESS IceFishingPa ,their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used for the activity ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

In addition, I hereby grant IceFishingPa ,their officers, officials, agents and/or employees,  sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used for the activity  permission to use my photograph or video image in any and all publications and media, including web site entries, without payment or any other consideration in perpetuity.
I hereby authorize IceFishingPA to edit, alter, copy, exhibit, publish or distribute any photo, video or images. I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my photo appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph.
I hereby hold harmless IceFishingPa ,their officers, officials, agents and/or employees,  sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used for the activity and grant permission to use my photograph or video and release and forever discharge from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf of on behalf of my estate which may have or may have by reason of this authorization.

Furthurmore, I have read and fully understand all the rules and regulations of such event.

I am 18 years of age or older and am competent to contract in my own name. I have read this release, and I fully understand the contents, meaning, and impact of this release.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT , FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Angler One signature____________________________  Angler Two signature_________________________________

Date____________________________                             Date____________________

________________________________________________________________________________________________________________________ 

To enter by credit card, use the pay-pal buttons below, you do not need a pay-pal account to use this feature. Make sure to choose which option you want; with optional Big Fish or without.

If possible, we would ask that after paying by credit card you print,  fill out and mail us the registration form. (write paid on it)  This is not a requirement, but will save time at the registration/rules meeting.