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4th Annual COASTAL CLAYS

PARTICIPANT & VOLUNTEER & TRAPPER

RELEASE FORM 2021

March 27th, 2021

 

Release of Liability

RELEASE FROM RESPONSIBILITY, WAIVER OF LIABILITY AND ASSUMPTION OF RISK FOR PARTICIPATION IN A DANGEROUS ACTIVITY.

FOR AND IN CONSIDERATION of permitting THE UNDERSIGNED to participate in shooting activities on Mullek Farms, Joe & Betty Mullek premises, and the Coastal Clay Sporting event for the purposes of firearms use, shooting firearms, observing the shooting of firearms, or any and all other purposes, THE UNDERSIGNED, for herself, himself, her/his heirs, executors, administrators and assigns:

Hereby voluntarily releases discharges, waives and relinquishes any and all actions for the personal injury, property damage or wrongful death occurring to the UNDERSIGNED arising as a result of engaging in or being present at the activities at the COASTAL CLAYS of Alabama, INC., Mullek Farms, Joe & Betty Mullek premises.

Acknowledges that the UNDERSIGNED has been fully and completely advised of the potential for serious accident incidental to engaging in firearm activities, and expressly agrees to assume all risks of loss, injury and property damage, and expressly agrees to assume all risks of loss, damage or injury that may be sustained by the UNDERSIGNED.

I, the undersigned do hereby release and discharge (1) Mullek Farms, Joe & Betty Mullek, Tim & Roberta Mullek “Coastal Clays of Alabama, INC.”, their officers, directors, employees, agents and appointees including associates, agents, invitees, employees and subcontractors, ("Indemnitees") and (2) companies subsidiary to, parent to, or affiliated with Indemnitees: (3) the executive personnel of all companies included in the foregoing (4) and insurers of any of them (hereinafter the group) against any and all claims that I may have as a result of my participation in the 4th Annual Coastal Clays anytime during the 2021 year. Furthermore, I hereby state that I am aware of the risks, hazards, and dangers associated with the Coastal Clays sponsored by the group. I understand that my participation in the 4th Annual Coastal Clays anytime during the 2021 year is conditioned upon my signing this Release.

I do hereby irrevocably authorize the Group, its successors and assigns and those acting under its permission authority to copyright, use and publish, for any art, advertising, trade or any other lawful purpose whatsover video reproductions or still photography reproductions of me in which I may appear in whole or in part in conjunction with my participation in the 4th Annual Coastal Clays anytime during the 2021 year. I do hereby waive any right that I may have to inspect or approve the finished product for the advertising that may be used in conjunction therewith or the use to which it may be applied. I hereby release and discharge the Group, its successors and assigns and all persons acting under its permissions and authority for any liability by virtue of the use of the video or still reproductions and waive any claim to payment or any other remuneration from any publication, sell or use thereof.

THE UNDERSIGNED HAS READ THE FOREGOING PARAGRAPHS AND VOLUNTARILY SIGNS THIS AGREEMENT BEING FULLY AWARE OF THE LEGAL CONSEQUENCES OF THE SIGNED INSTRUMENT WITHIN

I Agree

Coastal Clays PARENTAL/GUARDIAN COVID-19 CONSENT FORM AND LIABILITY WAIVER

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and as a result, social distancing is recommended. Coastal Clays will follow state and local standards of conduct and has put in place reasonable preventative measures to reduce the spread of COVID-19 at its 2021 Clay Shoot activities (including but not limited to the clay shoot and trapper training). However, even though such standards will be followed and reasonable measures put into place, Coastal Clays cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending the Coastal Clay activities could increase your risk and your child(ren)’s risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child(ren) and I may be exposed to or infected by COVID-19 by participating in the Coastal Clay activities and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at Coastal Clay activities may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Coastal Clay volunteers, and program participants and their families. Considering the foregoing, however, I, grant permission for my child, to participate in the Coastal Clay activities at the clay shoot site, notwithstanding the risks associated with the COVID-19 virus and group activities. I further agree on behalf of myself, my child named herein, and my spouse, our heirs, successors, and assigns, to release, indemnify, and hold harmless Coastal Clays, their members, directors, officers, agents and representatives (“Indemnitees”) associated with the event arising from or in connection with the negligent acts or omissions of the Indemnitees ONLY in regard to prevention of the spread of the COVID-19 virus. I SPECIFICALLY ACKNOWLEDGE AND AGREE TO THE FOREGOING. 

Today's Date: May 13, 2021

Please select how you will will be participating in the 4th Annual Coastal Clays...
AdultMinor(s)
1 Minor2 Minors3 Minors4 Minors5 MinorsMore Minors6 Minors7 Minors8 Minors9 Minors10 Minors
Continue
First Participant's(Shooters) & Volunteers & Trappers Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's(Shooters) & Volunteers & Trappers Date of Birth*
First Participant's(Shooters) & Volunteers & Trappers Information
Check either Participant/shooter or Volunteer or Trapper or Other *
Team Captain ( Person responsible for the Donation/Entry Fee , Please pick Shirt Size and Team Name if listed)
Participant/Shooter ( If checking this box please pick your shirt size as well as the Team you are shooting for, if you know )
Trapper ( If you check this box , please pick your shirt size, DO NOT pick a team below. )
other (i.e. Driver for a team, just visiting, Riding along and not shooting)
Volunteer (I am volunteering my Time and Energy for Coastal Clays)
Spectator (I may participate in Yard Games, Stay for Drawdown and generally stay for Fellowship)

Trappers Only- If you wish to receive updates about future Coastal Clays events enter your email in box:
If you are Team Captain and responsible for Donation/Entry Fee you have three options:
I am paying Cash or Check day of event
I will mail check to Coastal Clays P.O. Box 2675 Robertsdale, Ala 36567
I would like to pay by Credit Card. Please call Bryan Neth 251-550-7588 for more info
Check your T-shirt size (Pick One) (Adult Sizes)
Medium
Large
X-Large
2x Large
3x Large
If you are a Shooter check whose Team you will be shooting for, if you are NOT a Shooter pick another option: *
I do not know what team I am Shooting for??
I am a Trapper, This does NOT apply
Team ABM Education Services
I am a Volunteer, This does NOT apply.
I am a Spectator- This does NOT apply
I chose "Other" ( i.e. Driver for a team, just visiting, riding along and not shooting)
MY team name is not listed, please add name to Team Listings
Team Adamski
Team Gibb's Farm
Team BelleShainKennels.com
Team MH3 Printing
Team O'Hara Watkins, LLC
Team Eddie Youngblood Builders, Inc
Team Premier Medical
Team Alabama Ag Credit
Team Fibertech Industries
Team Bertolla Farm Supply
Team Agromax
Team Corteva Seed
Team Esfeller Construction
Team Layco Marine 1
Team Layco Marine 2
Team Encore Azalea
Team Sunsouth
Team SSIU
Team Campbell Hardware
Team Helena
Team Oneil/White
Team Wholesale Solutions
Team Klumb Forest Products
Team Sun South
Team JR Petelinski
Team St. Michael Sports
Team Rivieria Utilities
Team GA West
Team High Cotton
Team Vantage South
Team Elberta Co-op

If your Team is not Listed please type your team name to be added to the List,

Click to customize text box label
First Participant's(Shooters) & Volunteers & Trappers Signature*
Second Participant's(Shooters) & Volunteers & Trappers Name

First Name*

Middle Name

Last Name*
Second Participant's(Shooters) & Volunteers & Trappers Date of Birth*
Second Participant's(Shooters) & Volunteers & Trappers Information
Check either Participant/shooter or Volunteer or Trapper or Other *
Team Captain ( Person responsible for the Donation/Entry Fee , Please pick Shirt Size and Team Name if listed)
Participant/Shooter ( If checking this box please pick your shirt size as well as the Team you are shooting for, if you know )
Trapper ( If you check this box , please pick your shirt size, DO NOT pick a team below. )
other (i.e. Driver for a team, just visiting, Riding along and not shooting)
Volunteer (I am volunteering my Time and Energy for Coastal Clays)
Spectator (I may participate in Yard Games, Stay for Drawdown and generally stay for Fellowship)

Trappers Only- If you wish to receive updates about future Coastal Clays events enter your email in box:
If you are Team Captain and responsible for Donation/Entry Fee you have three options:
I am paying Cash or Check day of event
I will mail check to Coastal Clays P.O. Box 2675 Robertsdale, Ala 36567
I would like to pay by Credit Card. Please call Bryan Neth 251-550-7588 for more info
Check your T-shirt size (Pick One) (Adult Sizes)
Medium
Large
X-Large
2x Large
3x Large
If you are a Shooter check whose Team you will be shooting for, if you are NOT a Shooter pick another option: *
I do not know what team I am Shooting for??
I am a Trapper, This does NOT apply
Team ABM Education Services
I am a Volunteer, This does NOT apply.
I am a Spectator- This does NOT apply
I chose "Other" ( i.e. Driver for a team, just visiting, riding along and not shooting)
MY team name is not listed, please add name to Team Listings
Team Adamski
Team Gibb's Farm
Team BelleShainKennels.com
Team MH3 Printing
Team O'Hara Watkins, LLC
Team Eddie Youngblood Builders, Inc
Team Premier Medical
Team Alabama Ag Credit
Team Fibertech Industries
Team Bertolla Farm Supply
Team Agromax
Team Corteva Seed
Team Esfeller Construction
Team Layco Marine 1
Team Layco Marine 2
Team Encore Azalea
Team Sunsouth
Team SSIU
Team Campbell Hardware
Team Helena
Team Oneil/White
Team Wholesale Solutions
Team Klumb Forest Products
Team Sun South
Team JR Petelinski
Team St. Michael Sports
Team Rivieria Utilities
Team GA West
Team High Cotton
Team Vantage South
Team Elberta Co-op

If your Team is not Listed please type your team name to be added to the List,

Click to customize text box label
Third Participant's(Shooters) & Volunteers & Trappers Name

First Name*

Middle Name

Last Name*
Third Participant's(Shooters) & Volunteers & Trappers Date of Birth*
Third Participant's(Shooters) & Volunteers & Trappers Information
Check either Participant/shooter or Volunteer or Trapper or Other *
Team Captain ( Person responsible for the Donation/Entry Fee , Please pick Shirt Size and Team Name if listed)
Participant/Shooter ( If checking this box please pick your shirt size as well as the Team you are shooting for, if you know )
Trapper ( If you check this box , please pick your shirt size, DO NOT pick a team below. )
other (i.e. Driver for a team, just visiting, Riding along and not shooting)
Volunteer (I am volunteering my Time and Energy for Coastal Clays)
Spectator (I may participate in Yard Games, Stay for Drawdown and generally stay for Fellowship)

Trappers Only- If you wish to receive updates about future Coastal Clays events enter your email in box:
If you are Team Captain and responsible for Donation/Entry Fee you have three options:
I am paying Cash or Check day of event
I will mail check to Coastal Clays P.O. Box 2675 Robertsdale, Ala 36567
I would like to pay by Credit Card. Please call Bryan Neth 251-550-7588 for more info
Check your T-shirt size (Pick One) (Adult Sizes)
Medium
Large
X-Large
2x Large
3x Large
If you are a Shooter check whose Team you will be shooting for, if you are NOT a Shooter pick another option: *
I do not know what team I am Shooting for??
I am a Trapper, This does NOT apply
Team ABM Education Services
I am a Volunteer, This does NOT apply.
I am a Spectator- This does NOT apply
I chose "Other" ( i.e. Driver for a team, just visiting, riding along and not shooting)
MY team name is not listed, please add name to Team Listings
Team Adamski
Team Gibb's Farm
Team BelleShainKennels.com
Team MH3 Printing
Team O'Hara Watkins, LLC
Team Eddie Youngblood Builders, Inc
Team Premier Medical
Team Alabama Ag Credit
Team Fibertech Industries
Team Bertolla Farm Supply
Team Agromax
Team Corteva Seed
Team Esfeller Construction
Team Layco Marine 1
Team Layco Marine 2
Team Encore Azalea
Team Sunsouth
Team SSIU
Team Campbell Hardware
Team Helena
Team Oneil/White
Team Wholesale Solutions
Team Klumb Forest Products
Team Sun South
Team JR Petelinski
Team St. Michael Sports
Team Rivieria Utilities
Team GA West
Team High Cotton
Team Vantage South
Team Elberta Co-op

If your Team is not Listed please type your team name to be added to the List,

Click to customize text box label
Fourth Participant's(Shooters) & Volunteers & Trappers Name

First Name*

Middle Name

Last Name*
Fourth Participant's(Shooters) & Volunteers & Trappers Date of Birth*
Fourth Participant's(Shooters) & Volunteers & Trappers Information
Check either Participant/shooter or Volunteer or Trapper or Other *
Team Captain ( Person responsible for the Donation/Entry Fee , Please pick Shirt Size and Team Name if listed)
Participant/Shooter ( If checking this box please pick your shirt size as well as the Team you are shooting for, if you know )
Trapper ( If you check this box , please pick your shirt size, DO NOT pick a team below. )
other (i.e. Driver for a team, just visiting, Riding along and not shooting)
Volunteer (I am volunteering my Time and Energy for Coastal Clays)
Spectator (I may participate in Yard Games, Stay for Drawdown and generally stay for Fellowship)

Trappers Only- If you wish to receive updates about future Coastal Clays events enter your email in box:
If you are Team Captain and responsible for Donation/Entry Fee you have three options:
I am paying Cash or Check day of event
I will mail check to Coastal Clays P.O. Box 2675 Robertsdale, Ala 36567
I would like to pay by Credit Card. Please call Bryan Neth 251-550-7588 for more info
Check your T-shirt size (Pick One) (Adult Sizes)
Medium
Large
X-Large
2x Large
3x Large
If you are a Shooter check whose Team you will be shooting for, if you are NOT a Shooter pick another option: *
I do not know what team I am Shooting for??
I am a Trapper, This does NOT apply
Team ABM Education Services
I am a Volunteer, This does NOT apply.
I am a Spectator- This does NOT apply
I chose "Other" ( i.e. Driver for a team, just visiting, riding along and not shooting)
MY team name is not listed, please add name to Team Listings
Team Adamski
Team Gibb's Farm
Team BelleShainKennels.com
Team MH3 Printing
Team O'Hara Watkins, LLC
Team Eddie Youngblood Builders, Inc
Team Premier Medical
Team Alabama Ag Credit
Team Fibertech Industries
Team Bertolla Farm Supply
Team Agromax
Team Corteva Seed
Team Esfeller Construction
Team Layco Marine 1
Team Layco Marine 2
Team Encore Azalea
Team Sunsouth
Team SSIU
Team Campbell Hardware
Team Helena
Team Oneil/White
Team Wholesale Solutions
Team Klumb Forest Products
Team Sun South
Team JR Petelinski
Team St. Michael Sports
Team Rivieria Utilities
Team GA West
Team High Cotton
Team Vantage South
Team Elberta Co-op

If your Team is not Listed please type your team name to be added to the List,

Click to customize text box label
Fifth Participant's(Shooters) & Volunteers & Trappers Name

First Name*

Middle Name

Last Name*
Fifth Participant's(Shooters) & Volunteers & Trappers Date of Birth*
Fifth Participant's(Shooters) & Volunteers & Trappers Information
Check either Participant/shooter or Volunteer or Trapper or Other *
Team Captain ( Person responsible for the Donation/Entry Fee , Please pick Shirt Size and Team Name if listed)
Participant/Shooter ( If checking this box please pick your shirt size as well as the Team you are shooting for, if you know )
Trapper ( If you check this box , please pick your shirt size, DO NOT pick a team below. )
other (i.e. Driver for a team, just visiting, Riding along and not shooting)
Volunteer (I am volunteering my Time and Energy for Coastal Clays)
Spectator (I may participate in Yard Games, Stay for Drawdown and generally stay for Fellowship)

Trappers Only- If you wish to receive updates about future Coastal Clays events enter your email in box:
If you are Team Captain and responsible for Donation/Entry Fee you have three options:
I am paying Cash or Check day of event
I will mail check to Coastal Clays P.O. Box 2675 Robertsdale, Ala 36567
I would like to pay by Credit Card. Please call Bryan Neth 251-550-7588 for more info
Check your T-shirt size (Pick One) (Adult Sizes)
Medium
Large
X-Large
2x Large
3x Large
If you are a Shooter check whose Team you will be shooting for, if you are NOT a Shooter pick another option: *
I do not know what team I am Shooting for??
I am a Trapper, This does NOT apply
Team ABM Education Services
I am a Volunteer, This does NOT apply.
I am a Spectator- This does NOT apply
I chose "Other" ( i.e. Driver for a team, just visiting, riding along and not shooting)
MY team name is not listed, please add name to Team Listings
Team Adamski
Team Gibb's Farm
Team BelleShainKennels.com
Team MH3 Printing
Team O'Hara Watkins, LLC
Team Eddie Youngblood Builders, Inc
Team Premier Medical
Team Alabama Ag Credit
Team Fibertech Industries
Team Bertolla Farm Supply
Team Agromax
Team Corteva Seed
Team Esfeller Construction
Team Layco Marine 1
Team Layco Marine 2
Team Encore Azalea
Team Sunsouth
Team SSIU
Team Campbell Hardware
Team Helena
Team Oneil/White
Team Wholesale Solutions
Team Klumb Forest Products
Team Sun South
Team JR Petelinski
Team St. Michael Sports
Team Rivieria Utilities
Team GA West
Team High Cotton
Team Vantage South
Team Elberta Co-op

If your Team is not Listed please type your team name to be added to the List,

Click to customize text box label
Sixth Participant's(Shooters) & Volunteers & Trappers Name

First Name*

Middle Name

Last Name*
Sixth Participant's(Shooters) & Volunteers & Trappers Date of Birth*
Sixth Participant's(Shooters) & Volunteers & Trappers Information
Check either Participant/shooter or Volunteer or Trapper or Other *
Team Captain ( Person responsible for the Donation/Entry Fee , Please pick Shirt Size and Team Name if listed)
Participant/Shooter ( If checking this box please pick your shirt size as well as the Team you are shooting for, if you know )
Trapper ( If you check this box , please pick your shirt size, DO NOT pick a team below. )
other (i.e. Driver for a team, just visiting, Riding along and not shooting)
Volunteer (I am volunteering my Time and Energy for Coastal Clays)
Spectator (I may participate in Yard Games, Stay for Drawdown and generally stay for Fellowship)

Trappers Only- If you wish to receive updates about future Coastal Clays events enter your email in box:
If you are Team Captain and responsible for Donation/Entry Fee you have three options:
I am paying Cash or Check day of event
I will mail check to Coastal Clays P.O. Box 2675 Robertsdale, Ala 36567
I would like to pay by Credit Card. Please call Bryan Neth 251-550-7588 for more info
Check your T-shirt size (Pick One) (Adult Sizes)
Medium
Large
X-Large
2x Large
3x Large
If you are a Shooter check whose Team you will be shooting for, if you are NOT a Shooter pick another option: *
I do not know what team I am Shooting for??
I am a Trapper, This does NOT apply
Team ABM Education Services
I am a Volunteer, This does NOT apply.
I am a Spectator- This does NOT apply
I chose "Other" ( i.e. Driver for a team, just visiting, riding along and not shooting)
MY team name is not listed, please add name to Team Listings
Team Adamski
Team Gibb's Farm
Team BelleShainKennels.com
Team MH3 Printing
Team O'Hara Watkins, LLC
Team Eddie Youngblood Builders, Inc
Team Premier Medical
Team Alabama Ag Credit
Team Fibertech Industries
Team Bertolla Farm Supply
Team Agromax
Team Corteva Seed
Team Esfeller Construction
Team Layco Marine 1
Team Layco Marine 2
Team Encore Azalea
Team Sunsouth
Team SSIU
Team Campbell Hardware
Team Helena
Team Oneil/White
Team Wholesale Solutions
Team Klumb Forest Products
Team Sun South
Team JR Petelinski
Team St. Michael Sports
Team Rivieria Utilities
Team GA West
Team High Cotton
Team Vantage South
Team Elberta Co-op

If your Team is not Listed please type your team name to be added to the List,

Click to customize text box label
Seventh Participant's(Shooters) & Volunteers & Trappers Name

First Name*

Middle Name

Last Name*
Seventh Participant's(Shooters) & Volunteers & Trappers Date of Birth*
Seventh Participant's(Shooters) & Volunteers & Trappers Information
Check either Participant/shooter or Volunteer or Trapper or Other *
Team Captain ( Person responsible for the Donation/Entry Fee , Please pick Shirt Size and Team Name if listed)
Participant/Shooter ( If checking this box please pick your shirt size as well as the Team you are shooting for, if you know )
Trapper ( If you check this box , please pick your shirt size, DO NOT pick a team below. )
other (i.e. Driver for a team, just visiting, Riding along and not shooting)
Volunteer (I am volunteering my Time and Energy for Coastal Clays)
Spectator (I may participate in Yard Games, Stay for Drawdown and generally stay for Fellowship)

Trappers Only- If you wish to receive updates about future Coastal Clays events enter your email in box:
If you are Team Captain and responsible for Donation/Entry Fee you have three options:
I am paying Cash or Check day of event
I will mail check to Coastal Clays P.O. Box 2675 Robertsdale, Ala 36567
I would like to pay by Credit Card. Please call Bryan Neth 251-550-7588 for more info
Check your T-shirt size (Pick One) (Adult Sizes)
Medium
Large
X-Large
2x Large
3x Large
If you are a Shooter check whose Team you will be shooting for, if you are NOT a Shooter pick another option: *
I do not know what team I am Shooting for??
I am a Trapper, This does NOT apply
Team ABM Education Services
I am a Volunteer, This does NOT apply.
I am a Spectator- This does NOT apply
I chose "Other" ( i.e. Driver for a team, just visiting, riding along and not shooting)
MY team name is not listed, please add name to Team Listings
Team Adamski
Team Gibb's Farm
Team BelleShainKennels.com
Team MH3 Printing
Team O'Hara Watkins, LLC
Team Eddie Youngblood Builders, Inc
Team Premier Medical
Team Alabama Ag Credit
Team Fibertech Industries
Team Bertolla Farm Supply
Team Agromax
Team Corteva Seed
Team Esfeller Construction
Team Layco Marine 1
Team Layco Marine 2
Team Encore Azalea
Team Sunsouth
Team SSIU
Team Campbell Hardware
Team Helena
Team Oneil/White
Team Wholesale Solutions
Team Klumb Forest Products
Team Sun South
Team JR Petelinski
Team St. Michael Sports
Team Rivieria Utilities
Team GA West
Team High Cotton
Team Vantage South
Team Elberta Co-op

If your Team is not Listed please type your team name to be added to the List,

Click to customize text box label
Eighth Participant's(Shooters) & Volunteers & Trappers Name

First Name*

Middle Name

Last Name*
Eighth Participant's(Shooters) & Volunteers & Trappers Date of Birth*
Eighth Participant's(Shooters) & Volunteers & Trappers Information
Check either Participant/shooter or Volunteer or Trapper or Other *
Team Captain ( Person responsible for the Donation/Entry Fee , Please pick Shirt Size and Team Name if listed)
Participant/Shooter ( If checking this box please pick your shirt size as well as the Team you are shooting for, if you know )
Trapper ( If you check this box , please pick your shirt size, DO NOT pick a team below. )
other (i.e. Driver for a team, just visiting, Riding along and not shooting)
Volunteer (I am volunteering my Time and Energy for Coastal Clays)
Spectator (I may participate in Yard Games, Stay for Drawdown and generally stay for Fellowship)

Trappers Only- If you wish to receive updates about future Coastal Clays events enter your email in box:
If you are Team Captain and responsible for Donation/Entry Fee you have three options:
I am paying Cash or Check day of event
I will mail check to Coastal Clays P.O. Box 2675 Robertsdale, Ala 36567
I would like to pay by Credit Card. Please call Bryan Neth 251-550-7588 for more info
Check your T-shirt size (Pick One) (Adult Sizes)
Medium
Large
X-Large
2x Large
3x Large
If you are a Shooter check whose Team you will be shooting for, if you are NOT a Shooter pick another option: *
I do not know what team I am Shooting for??
I am a Trapper, This does NOT apply
Team ABM Education Services
I am a Volunteer, This does NOT apply.
I am a Spectator- This does NOT apply
I chose "Other" ( i.e. Driver for a team, just visiting, riding along and not shooting)
MY team name is not listed, please add name to Team Listings
Team Adamski
Team Gibb's Farm
Team BelleShainKennels.com
Team MH3 Printing
Team O'Hara Watkins, LLC
Team Eddie Youngblood Builders, Inc
Team Premier Medical
Team Alabama Ag Credit
Team Fibertech Industries
Team Bertolla Farm Supply
Team Agromax
Team Corteva Seed
Team Esfeller Construction
Team Layco Marine 1
Team Layco Marine 2
Team Encore Azalea
Team Sunsouth
Team SSIU
Team Campbell Hardware
Team Helena
Team Oneil/White
Team Wholesale Solutions
Team Klumb Forest Products
Team Sun South
Team JR Petelinski
Team St. Michael Sports
Team Rivieria Utilities
Team GA West
Team High Cotton
Team Vantage South
Team Elberta Co-op

If your Team is not Listed please type your team name to be added to the List,

Click to customize text box label
Ninth Participant's(Shooters) & Volunteers & Trappers Name

First Name*

Middle Name

Last Name*
Ninth Participant's(Shooters) & Volunteers & Trappers Date of Birth*
Ninth Participant's(Shooters) & Volunteers & Trappers Information
Check either Participant/shooter or Volunteer or Trapper or Other *
Team Captain ( Person responsible for the Donation/Entry Fee , Please pick Shirt Size and Team Name if listed)
Participant/Shooter ( If checking this box please pick your shirt size as well as the Team you are shooting for, if you know )
Trapper ( If you check this box , please pick your shirt size, DO NOT pick a team below. )
other (i.e. Driver for a team, just visiting, Riding along and not shooting)
Volunteer (I am volunteering my Time and Energy for Coastal Clays)
Spectator (I may participate in Yard Games, Stay for Drawdown and generally stay for Fellowship)

Trappers Only- If you wish to receive updates about future Coastal Clays events enter your email in box:
If you are Team Captain and responsible for Donation/Entry Fee you have three options:
I am paying Cash or Check day of event
I will mail check to Coastal Clays P.O. Box 2675 Robertsdale, Ala 36567
I would like to pay by Credit Card. Please call Bryan Neth 251-550-7588 for more info
Check your T-shirt size (Pick One) (Adult Sizes)
Medium
Large
X-Large
2x Large
3x Large
If you are a Shooter check whose Team you will be shooting for, if you are NOT a Shooter pick another option: *
I do not know what team I am Shooting for??
I am a Trapper, This does NOT apply
Team ABM Education Services
I am a Volunteer, This does NOT apply.
I am a Spectator- This does NOT apply
I chose "Other" ( i.e. Driver for a team, just visiting, riding along and not shooting)
MY team name is not listed, please add name to Team Listings
Team Adamski
Team Gibb's Farm
Team BelleShainKennels.com
Team MH3 Printing
Team O'Hara Watkins, LLC
Team Eddie Youngblood Builders, Inc
Team Premier Medical
Team Alabama Ag Credit
Team Fibertech Industries
Team Bertolla Farm Supply
Team Agromax
Team Corteva Seed
Team Esfeller Construction
Team Layco Marine 1
Team Layco Marine 2
Team Encore Azalea
Team Sunsouth
Team SSIU
Team Campbell Hardware
Team Helena
Team Oneil/White
Team Wholesale Solutions
Team Klumb Forest Products
Team Sun South
Team JR Petelinski
Team St. Michael Sports
Team Rivieria Utilities
Team GA West
Team High Cotton
Team Vantage South
Team Elberta Co-op

If your Team is not Listed please type your team name to be added to the List,

Click to customize text box label
Tenth Participant's(Shooters) & Volunteers & Trappers Name

First Name*

Middle Name

Last Name*
Tenth Participant's(Shooters) & Volunteers & Trappers Date of Birth*
Tenth Participant's(Shooters) & Volunteers & Trappers Information
Check either Participant/shooter or Volunteer or Trapper or Other *
Team Captain ( Person responsible for the Donation/Entry Fee , Please pick Shirt Size and Team Name if listed)
Participant/Shooter ( If checking this box please pick your shirt size as well as the Team you are shooting for, if you know )
Trapper ( If you check this box , please pick your shirt size, DO NOT pick a team below. )
other (i.e. Driver for a team, just visiting, Riding along and not shooting)
Volunteer (I am volunteering my Time and Energy for Coastal Clays)
Spectator (I may participate in Yard Games, Stay for Drawdown and generally stay for Fellowship)

Trappers Only- If you wish to receive updates about future Coastal Clays events enter your email in box:
If you are Team Captain and responsible for Donation/Entry Fee you have three options:
I am paying Cash or Check day of event
I will mail check to Coastal Clays P.O. Box 2675 Robertsdale, Ala 36567
I would like to pay by Credit Card. Please call Bryan Neth 251-550-7588 for more info
Check your T-shirt size (Pick One) (Adult Sizes)
Medium
Large
X-Large
2x Large
3x Large
If you are a Shooter check whose Team you will be shooting for, if you are NOT a Shooter pick another option: *
I do not know what team I am Shooting for??
I am a Trapper, This does NOT apply
Team ABM Education Services
I am a Volunteer, This does NOT apply.
I am a Spectator- This does NOT apply
I chose "Other" ( i.e. Driver for a team, just visiting, riding along and not shooting)
MY team name is not listed, please add name to Team Listings
Team Adamski
Team Gibb's Farm
Team BelleShainKennels.com
Team MH3 Printing
Team O'Hara Watkins, LLC
Team Eddie Youngblood Builders, Inc
Team Premier Medical
Team Alabama Ag Credit
Team Fibertech Industries
Team Bertolla Farm Supply
Team Agromax
Team Corteva Seed
Team Esfeller Construction
Team Layco Marine 1
Team Layco Marine 2
Team Encore Azalea
Team Sunsouth
Team SSIU
Team Campbell Hardware
Team Helena
Team Oneil/White
Team Wholesale Solutions
Team Klumb Forest Products
Team Sun South
Team JR Petelinski
Team St. Michael Sports
Team Rivieria Utilities
Team GA West
Team High Cotton
Team Vantage South
Team Elberta Co-op

If your Team is not Listed please type your team name to be added to the List,

Click to customize text box label
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information about future Coastal Clays Events.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Check either Participant/shooter or Volunteer or Trapper or Other *
Team Captain ( Person responsible for the Donation/Entry Fee , Please pick Shirt Size and Team Name if listed)
Participant/Shooter ( If checking this box please pick your shirt size as well as the Team you are shooting for, if you know )
Trapper ( If you check this box , please pick your shirt size, DO NOT pick a team below. )
other (i.e. Driver for a team, just visiting, Riding along and not shooting)
Volunteer (I am volunteering my Time and Energy for Coastal Clays)
Spectator (I may participate in Yard Games, Stay for Drawdown and generally stay for Fellowship)

Trappers Only- If you wish to receive updates about future Coastal Clays events enter your email in box:
If you are Team Captain and responsible for Donation/Entry Fee you have three options:
I am paying Cash or Check day of event
I will mail check to Coastal Clays P.O. Box 2675 Robertsdale, Ala 36567
I would like to pay by Credit Card. Please call Bryan Neth 251-550-7588 for more info
Check your T-shirt size (Pick One) (Adult Sizes)
Medium
Large
X-Large
2x Large
3x Large
If you are a Shooter check whose Team you will be shooting for, if you are NOT a Shooter pick another option: *
I do not know what team I am Shooting for??
I am a Trapper, This does NOT apply
Team ABM Education Services
I am a Volunteer, This does NOT apply.
I am a Spectator- This does NOT apply
I chose "Other" ( i.e. Driver for a team, just visiting, riding along and not shooting)
MY team name is not listed, please add name to Team Listings
Team Adamski
Team Gibb's Farm
Team BelleShainKennels.com
Team MH3 Printing
Team O'Hara Watkins, LLC
Team Eddie Youngblood Builders, Inc
Team Premier Medical
Team Alabama Ag Credit
Team Fibertech Industries
Team Bertolla Farm Supply
Team Agromax
Team Corteva Seed
Team Esfeller Construction
Team Layco Marine 1
Team Layco Marine 2
Team Encore Azalea
Team Sunsouth
Team SSIU
Team Campbell Hardware
Team Helena
Team Oneil/White
Team Wholesale Solutions
Team Klumb Forest Products
Team Sun South
Team JR Petelinski
Team St. Michael Sports
Team Rivieria Utilities
Team GA West
Team High Cotton
Team Vantage South
Team Elberta Co-op

If your Team is not Listed please type your team name to be added to the List,

Click to customize text box label
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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