The undersigned, parent/guardian of the above-named applicant, hereby requests applicant's registration the B.P.O. Elks "Soccer Shoot"® GOAL SHOOTING CONTEST and represents the information set forth in this Application is correct. In consideration of such registration and the right of the applicant to participate in the competition, the undersigned does hereby acknowledge. and agree that such participation will be solely the risk of the applicant and the undersigned and without liability to the Benevolent and Protective Order at Elks of the United States of America, its State Associations, its Local Lodges and the officers and members of them (hereinafter collectively referred to as "BPOE”). The undersigned, for himself, his personal representatives and succors, does hereby release and forever discharge BPOE from any and all claims, demands, liabilities, obligations, damages, costs, expenses, loss of service, actions and causes of action including each and every right of payment for damages said undersigned may now or hereafter have against BPOE arising out of any in act or occurrence incident to the applicant's said participation and/or the engagement of the undersigned connection therewith. The undersigned. hereby consents and authorizes BPOE to use and reproduce applicant's name and/or likeness and to circulate the same for any and all purposes reasonably related to the conduct and promotion of the said competition, and the undersigned does hereby agree to indemnify and hold BPOE harmless from any and all claims, loss or damage to the BPOE resulting from or related to applicant's said participation. have read, understood, and followed the rules of the "Soccer Shoot" contest.