Alligator Hunt Step 1 of 7 14% Participant Name* First Last Date of Birth* Date Format: MM slash DD slash YYYY Participant Social Security Number (for license purposes only)*Guardian Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Cell Phone*Email* Number of People Accompanying You (participant +2 max)*012Name of Accompany*FirstLast Name of Accompany*First1 Emergency Contact*NameNumberRelationship Select if this is your first time participating in the Super Hunt?*YesNoAre you a first time hunter?*YesNoIf no, what game have you hunted?Have you taken the hunter education course?*YesNoAre there any limitations of you being in a boat?*YesNo Please list the participant's disabilities.*T-shirt Size*Youth SYouth MYouth LAdult XSAdult SAdult MAdult LAdult XLAdult 2XLAdult 3XLPlease list any medications.*Does the participant have any known allergies?*Please list any additional information pertaining to the disability.*Please list any special equipment pertaining to the disability.* Physician Name*Physician Phone Number*Insert a file containing the disability formList any special needs required for the participant*List any sort of assistance the participant would need Waiver of Liability Relating to Coronavirus/COVID-19 The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is reported to be extremely contagious. The state of medical knowledge is evolving, but the virus is believed to spread from person-to-person contact and/or by contact with contaminated surfaces and objects, and even possibly in the air. People reportedly can be infected and show no symptoms and therefore spread the disease. The exact methods of spread and contraction are unknown, and there is no known treatment, cure, or vaccine for COVID-19. Evidence has shown that COVID-19 can cause serious and potentially life-threatening illness and even death. Although Southern Outdoors Unlimited (“SOU”) will take precautions to limit the spread of COVID-19, SOU cannot prevent you [or your child(ren)] from becoming exposed to, contracting, or spreading COVID-19 while participating in events sponsored or hosted by or in any way involving SOU. It is not possible to prevent against the presence of the disease. Therefore, if you choose to attend any SOU functions including, but not limited to, the Super Hunt, the SOU Banquet, or SOU Outdoor Adventure Day, you may be exposing yourself to and/or increasing your risk of contracting or spreading COVID-19. ASSUMPTION OF RISK: I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 for myself and/or my children in any event sponsored or hosted by or in any way involving SOU. These events are of such value to me [and/or to my children,] that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to attend these events in person. WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring suit against Southern Outdoors Unlimited and its owners, officers, directors, managers, officials, trustees, agents, employees, volunteers, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to my and/or my family’s participation in any event sponsored or hosted by or in any way involving SOU. I also forever release and waive my right to bring suit against any property owner who has donated the use of their property for a SOU event and on whose property I or my children may come in contact with and contract COVID-19. I understand that this waiver means I give up my right to bring any claims, including those for personal injuries, death, disease or property losses, or any other loss, including, but not limited to, claims of negligence, and I hereby give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen from SOU or any property owner who has donated the use of their property for a SOU event and on whose property I or my children may come in contact with and contract COVID-19. CHOICE OF LAW: I understand and agree that the law of the State of Mississippi will apply to this contract. I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE:Participant's Name* First Middle Last Date* Date Format: MM slash DD slash YYYY I am the parent or legal guardian of the minor named above. I have the legal right to consent to and, by signing below, I hereby do consent to the terms and conditions of this Release.Guardian's Name* First Middle Last Date* Date Format: MM slash DD slash YYYY I authorize Southern Outdoors Unlimited (“SOU”) and all related subsidiaries to use the Participant’s name, statements, and likeness, without charge, for promotional purposes in SOU publications, advertising, video, Web pages, or other formats. In addition, I hereby give to SOU, their assigns, agents, licensees, clients and principals, and their representatives, respective heirs, successors and assigns, the absolute right and permission to copyright, use, exhibit, display, print and publish, as advertising or for any other lawful purposes, all photographs, photographic negatives, motion picture films and/or magnetic video tapes, magnetic audio tapes, prints of every kind and nature, and all illustrations, pictures, designs, paintings, and drawings of every kind and nature, wherein the Participant appeared and/or posed or acted as model exclusively for SOU and any reproductions thereof, and made through any media; all without inspection, consent or approval by me of the finished product or of the use to which it may be applied. And for the same consideration I do hereby release SOU, their assigns, agents, licensees, clients and principals, and their respective heirs, representatives, successors and assigns of and from any liability for any and all claims, demands, injuries, damages and losses of whatsoever nature and character, heretofore sustained or which may be hereafter sustained, caused by or arising out of, directly or indirectly, the matters, acts, and circumstances hereinabove particularly referred to; and whether caused by any misrepresentation of me as a result of optical illusions, alterations, faulty, mechanical reproduction or otherwise. I am the parent or legal guardian of the Participant. I have read this document, have the authority to execute it, and I am executing it freely. I understand the legal consequences of signing this document, including (a) authorizing SOU to use the Participant’s name, statements, and likeness, without charge, for promotional purposes in SOU publications, advertising, video, Web pages, or other formats as stated above, and (b) releasing SOU from all liability on my and the Participant’s behalf. I agree to be bound by the terms of this document.Participant's Name* First Middle Last Date* Date Format: MM slash DD slash YYYY Guardian's Name* First Middle Last Date* Date Format: MM slash DD slash YYYY Event Registration Waiver and Release Of Liability Form Participant's Name* First Middle Last Participant's Gender*Participant's Date Of Birth* Date Format: MM slash DD slash YYYY Emergency Phone Number*Name Of Event*Start Date* Date Format: MM slash DD slash YYYY End Date* Date Format: MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged.
