Name:Birth Date: Phone Number: Emergency Contact (Name and Phone Number): Address: Preferred Division: Prone / Drop Knee / BothSex: M / F TEAM SECTION (OPTIONAL) Team Name: Team Members: Chosen Charity (must be 501(c)3 compliant): Rider Entry and Sponsorship Form Bodyboarding for a Cause! Liability Waiver INDEMNITY – In consideration of acceptance of my entry, I intend to be legally bound, do hereby for myself, my heirs, and administrators of the USBA/IBA, East Coast Bodyboarding, LLC (“ECBB”), and its affiliates release and forever discharge any and all rights and claims for damages which may hereafter accrue against the competition, its officials, employees, movement agencies and contest sponsors, of any and all liability and responsibility arising from any injury received or incurred by participating in this event. I will inspect the contest area and assure myself that the area is safe for bodyboarding and further agree that the area conditions are safe for bodyboarding purposes. Further, I acknowledge that I voluntarily assume all risks arising from the conditions relating to the use of the contest site and surfing area by me or by others. I will comply with the USBA/IBA/ECBB rules and any rules announced at the event. I agree to the release of all official photographs and video footage taken during this event and its use by the contest director and sponsors. MEDICAL PERMISSION – I hereby give my permission for Officials of the USBA/IBA/ECBB to seek any medical service that I (or my son/daughter if competitor is under 18) may require in case of accident. CONDUCT – I agree that I will behave myself appropriately at all times over the event and activities surrounding the event. I will abide by the USBA/IBA/ECBB rules for competitors at events and understand that my failure to do so may result in penalties. By signing I state that I have read the above and that all information provided is true and correct. Signature: _______________________________________ Date: _________________ Parent/Legal Guardian Signature: ______________________________ Date: _________________ BRING THESE FORMS WITH YOU TO THE CONTEST! PRE-REGISTER ONLINE AT

Full Name Payment Type (Circle One) Amount Cash / Check / PayPal Online Total : Sponsorship Form Levels Grommet ($10 - $50)Ripper ($51 - $150)Kahuna ($151+) Bodyboarding for a Cause! YOU CAN DONATE ONLINE AT

What is Bodyboarding for a Cause! ? This is a bodyboarding contest and beach festival hosted by EastCoastBodyboarding.com, in partnership with the USBA tour. The contest’s proceeds will benefit three main charities: Ocean’s Harbor House The American Red Cross SurfRider In addition, the winning team gets to select an additional charity* to receive a portion of the proceeds. Why sign up? To share and promote the stoke of bodyboarding on the East Coast, and to do it for the worthy cause of your choice! How do I sign up? Go to and click on the contest graphic for full instructionswww.ECBBing.com When will it happen? August 16 or 17, depending on weather conditions. Check on the night before/morning of! Registration will open at 6:30am Where will it be? South side of Casino Pier in Seaside Heights How can you help? Sign up as an individual, on a team, or both. Then tell family, friends, co-workers, anyone you think can help to sponsor you and / or your team (rider entry and sponsorship form on reverse side). There are 3 levels of sponsorship: Grom ($10-$50)Ripper ($51 - $150)Kahuna ($151+) Will there be prizes? Yes! The more money your sponsors give, the bigger the prize: Over $30: Free entry to contest & t-shirtOver $200: Free DVD Over $500: New pair of finsOver $1,000: New board There will be a free clinic for beginner bodyboarders, along with a beach festival during the contest, so bring family and friends! *Charity must be 501(c)3-compliant