Laurel Leap Day Team Entry Laurel Leap Day Team Entry Team Name* Name of Team Captain* Team Captain's Email* Team Captain's Phone*Team Members*First NameLast Name USE OF LIKENESS AND PHOTO RELEASE*The above team and members herby agree to allow the Laurel Leap committee to use any and all pictures, statements, videos or any other publicly related information or materials for the further promotion of these or similar events or promotions, and the Team Captain is aware that he/she is responsible for the conduct of his/her team members and guests I agree How would you like to pay?* PayPal By Mail At the Captains' Meeting RELEASE, COVENANT NOT TO SUE AND INDEMNITY AGREEMENT*I, and my heirs, in consideration of my participation in the Laurel Main Street Basketball Tournament on February 29, 2020 to be held in Downtown Laurel in Laurel, Mississippi, (hereinafter the “Event”), hereby release, acquit, and discharge and hold harmless Laurel Main Street and its Board of Directors, officers, agents, employees, volunteers, and insurers and all others persons and entities officially connected with the Event from any and all liability for damages to or loss of personal property, illness, personal injury, or death from whatever source which might occur while participating in this Event or as a result thereof. Specifically, I hereby release, acquit and discharge and hold harmless all persons from any liability or responsibility for my physical condition, for the condition of or selection of equipment, for court condition(s) thereof, and for the presence or actions of any other participants. I am aware of the risks of participation, which include, but are not limited to, the possibility of sprained and/or torn muscles and/or ligaments, broken bones, fatigue, more serious personal injury, disability, and/or death. I hereby warrant and state that I am in sufficient physical condition to accept a rigorous level of physical activity. I understand that participation in this program is strictly voluntary and I freely chose to participate. I understand that the Laurel Main Street does not provide medical coverage for me. I verify that I will be responsible for any and all medical costs I incur as a result of my participation. I agree Paying with PayPal* Price: $50.00 Quantity: Total $0.00 Paying by Mail*Please remit payment to: Laurel Main Street P.O. Box 1256 Laurel, MS 39441 I understand Paying at the Captains' Meeting*You may submit payment in the form of Cash, Check, or Money Order at the Captains' Meeting. The Mandatory Team Captain meeting is the Monday, PRIOR, to the event at 5:30pm at the Laurel Train Depot. I understand CAPTCHA Δ