HEADLINE SPONSOR

EVENT #3 SALT CREEK MAY 12TH, 2012 7AM-3PM

AWARDS & PRIZES 1
ST ST

- 4TH PL AMATUERS CONTEST INFO: For directions to our events visit our website. Heat times will be posted on our website the Friday before each event or call (310) PRO OPEN 1 - $ 250.00 ST 325-7938. Beach entries are on a 1st come 1st serve basis. All PRO DK 1 - $ 250.00
com petitors that PRE REGISTER will get a discount ($10 for AM / $25 for PRO).
WAVE REBEL CUSTOM X TOOBS VICTORY MADRID VIPER FINS NO. 6 PCA STICKY BUMPS - BBR MAGAZINE NO FRIENDS ALTERNATIVE SURF E-BODYBOARDING CALIFORNIA BOARD COMPANY

DIVISIONS
JUNIORS 17 & under MENS 18-29 DROP KNEE (scored on DK only)

AMATEUR MASTERS 30+ FEMALE STAND UP AAA (ELITE AMATUER)

PROFESSIONAL PRO OPEN PRO DROP KNEE

TH

BIA EVENT #3

A RATED EVENT ENTRY DEADLINE: MUST BE POSTMARKED ON OR BEFORE MAY 10 , 2012

DISCOUNT FOR ENTRY FEES (If pre-registered before entry deadline)

AMATEUR COMPETITORS $75.00 MEMBERSHIP FEE (1 EVENT $20.00) $50.00 CONTEST ENTRY FEE(Pre register $ 40.00) $20.00 ADDL DIVISION FEE $250.00 BULK RIDER FEE PROFESSIONAL COMPEITIORS $100.00 MEMBERSHIP FEE (1 EVENT $20.00) $100.00 PRO ENTRY FEE (Pre register $ 75.00) $100.00 PRO DK ENTRY FEE PRIZE MONEY PRO OPEN PRO DK
FORM OF PAYMENT CASH MO PLEASE CHECK BOX CHECK $_____________ AMOUNT $

Bulk Rider entry covers: BIA Membership fee and entry into all BIA regular season events except BIA Champs, Amateur riders save $55.00 by signing up for bulk rider membership.

MAKE CHECK OR MONEY ORDER PAYABLE TO: BIA / MAIL PAYMENT AND ENTRY TO: BIA PO BOX 306, LOMITA, CA 90717

NAME: ADDRESS: CITY:

DIVISION(s): PH: ( STATE:

ZIP:

READ & SIGN: In consideration of accepting this registration, I hereby certify the foregoing statements to be true and correct, and agree to indemnity and hold harmless to the State of California & the city of the Event, its City Officials, agents and/or volunteers, the political entity having jurisdiction over the contest site, the boy scouts, the BIA, its officers, directors, contest officials & employees such claim, suit, or action for damages resulting from or in any manner arising out of the participation in the BIA event I am entering. I do understand that any photographs or video taken of my likeness during my participation any/all BIA events is sole property of BODYBOARDER INTERNATIONAL ASSOCIATION and can be used at any time in any media form without my prior knowledge or consent. SIGN HERE: SIGNATURE (Parents, If Under 18) Birthdate / / Age: Date: / / I verify that I am the parent or legal guardian of the bodyboarder entering this contest. I hereby give full contest without reservation to the forgoing statement & agree to hold the BIA free from any / all liability, damages & claims. I also give consent to any medical treatment if / when needed.