ESA 2019 Southeast Regional Surfing Championships

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Presented by Scheduled Dates: April 26, 27 & 28, 2019 Tentative Schedule: Adults, Open Shortboard & SUP April 26. Open Shortboard, Bodyboard & SUP April 27. Youth (Under 18) April 27 & 28. Location: Melbourne Beach, Florida Howard E. Futch Memorial Park at Paradise Beach 2301 N. Highway A1A, Melbourne Beach, FL 32935 Information: Central Headquarters: Website for contest updates: info@surfesa.org http://www.surfesa.org/ AGE DIVISIONS FOR THIS EVENT (Age as of January 1, 2019) SHORTBOARD LONGBOARD Boys U12 (11 & Under) Menehune Longboard U14 (13 & Under M/F) Boys U14 (13 & Under) Junior Longboard U18 (17 & Under) Boys U16 (15 & Under) Mens Longboard (18-34) Junior Men U18 (17 & Under) Masters Longboard (35-49) Men (18-29) Legends Longboard (50+) Masters (30-39) Grand Legends Longboard (60+ M/F) Senior Men (40-49) Junior Womens Longboard U18 (17 & Under) Legends (50+) Womens Longboard (18-34) Grand Legends (60+ M/F) Ladies Longboard (35+) Girls U12 (11 & Under) Girls U14 (13 & Under) Girls U16 (15 & Under) Junior Women U18 (17 & Under) Women (18-34) Ladies (35+) OPEN BODYBOARD (All Ages M/F) OPEN SUP (All Ages M/F) OPEN SHORTBOARD (All Ages M/F) Eligibility: Competitors signing up for the 2019 Southeast Regionals must have competed in and qualified in their respective divisions during the 2018 District Season in order to be eligible to enter and compete. Competitors must sign-up before the April 1 deadline in order to reserve their slot. Any competitor applying for entry whose membership expires on or before September 30, 2019 must renew their membership along with their entry form and fee. (Please fill out the Membership Form and attach a money order only for membership renewal if renewing by mail. No personal checks please.) Entry: Please fill out the Entry Form and Hold Harmless Form on pages 3 and 4.

Entry Instructions for invited and alternate competitors: Entries for both invited and alternate competitors must be received by the Eastern Surfing Association on or before 11:59PM on Monday, April 1, 2019 through SurfSignup online or by postmarked mail. Online or mail entries not received or postmarked by the Eastern Surfing Association on or before 11:59PM on Monday, April 1, 2018 may be considered a late paid alternate. Note: There will be a $20 Late Fee for entries received after April 1, 2019. SurfSignup online at: surfsignup.com (Surf Signup convenience fee will be added to entry fee.) Mail Entry: (Mail to the address below using this downloadable entry form): Please complete the entry form below on pages 3 and 4 and enclose a money order only (no personal checks) for your entry fees, then mail to the IMMEDIATELY at: NOTE: If your membership expires before Sept 30, 2019 please fill out the membership form on page 5 and attach a separate money order for membership or renew online at SurfSignup.com. Refunds: Refunds must be requested by 11:59PM on Monday, April 15, 2019. The ESA will then issue any refund due to an official withdrawal or non-slotted competitor within 30 days from end of the 2019 Southeast Regional. Refund of any entry fees does not cover the SurfSignup convenience fee if you enter online. Any competitor wishing to withdraw must do so by email to receive a refund. Note: A $20 ESA processing fee will be deducted from the refund amount. To Withdraw: You must notify info@surfesa.org by email. (Email must be time stamped by 11:59PM on April 15, 2019). You must also notify your District Director by phone, cell phone or email so they can verify your withdrawal at the Official Slot Meeting. Refunds for Slotted Surfers: The ESA will issue a refund to any slotted surfer who officially withdraws by 11:59PM on April 15, 2019, 10 days or more prior to the start of the event. Any withdrawals after that date will forfeit their entry fee, except in the case of a medical emergency, which will receive a refund up until 9:00AM the day before the event (with proper documentation and approval of the Contest Director only). Any withdrawals after this time will result in forfeiture of all entry fees regardless of the circumstances involved. Refunds for Alternates: Alternates who are slotted less than 10 days before the event or have yet to receive a slot and wish to withdraw must do so before 9:00AM the day before the event to receive a refund. The ESA will also issue a refund to any alternate who does not receive a slot. The deadline for the Official Slot Meeting for any additional slotting of Alternates is Thursday, April 25, 2019 at 9:00AM. No beach entries.

Entry Form Check-in Friday, April 26, 2019-7:30AM SHARP! SEE NEXT PAGES FOR MANDATORY SIGNATURES! Contest Information: info@surfesa.org Official Website for updated Time/Heat information: http://www.surfesa.org/competition/southeast/ Entry Fee: $110.00 First Event / $90.00 Each Additional Event (Money Orders Only! No Personal Checks!) MAIL ENTRIES - INVITED COMPETITORS & ALTERNATES: DO NOT combine entry fees and membership fees in one money order. Attach separate money orders to each form. Two-part OFFICIAL ENTRY Form (pages 3 & 4) s Entry Deadline: 11:59PM on April 1, 2019 There will be a $20 late fee for entries received after April 1, 2019 Please mail Entry Form and Hold Harmless Release (next page) to: A contestant applying for entry whose membership expires before September 30, 2019 must renew membership. (See page 5 for membership renewal.) Date application was filled out: ESA District: Member s current expiration date: Name: Age (as of 01/01/2019): Date of Birth (mm/dd/yyyy): Mailing Address: City: State: Zip: Telephone (Home): E-mail Address: Emergency Contact-Name and Phone Number: Any known allergies to medications or other pertinent health issues: 1st Division Check if Alt : 3rd Division Check if Alt : 2nd Division Check if Alt : 4th Division Check if Alt : 5th Division Check if Alt : T-Shirt Size: Adult sizes only. (Please check your size.) (S) (M) (L) (XL) (XXL) First Entry Fee ($110) $ Additional Entry Fees ($90 each Division) $ Total fees enclosed (make payable to ESA) $ Money Orders Only! No personal checks accepted! Please make your money order payable to ESA and mail to:

Hold Harmless Release HOLD HARMLESS RELEASE MUST BE SIGNED AND RETURNED WITH ENTRY FORM IF ENTERING BY MAIL HOLD HARMLESS RELEASE: This release bars your rights to recover damages in the case of an accident injuring you. READ BEFORE SIGNING! In applying to the ESA surfing competitions and events, I promise to inspect the contest site, and assure myself that the area is safe for surfing, and further agree that I will not surf in the contest unless I am satisfied that the area and conditions are safe for surfing purposes. In exchange for the s accepting my entry form, I voluntarily agree to assume all risks incident to the sport of surfing. I fully understand and comprehend the dangers of surfing created by the sharp edges and fins along with the natural buoyancy of a surfboard when they are acted upon by the powerful forces of the ocean and ocean waves. With full knowledge, comprehension and understanding of these dangers, I voluntarily accept and assume all risks involved in the sport of competitive surfing. I will further read and comply with all the ESA rules and regulations, noting existing weather conditions, and do agree that I voluntarily assume all risks arising from conditions related to use of the contest site by myself and others. In consideration of your acceptance of my entry, I intend to be legally bound, hereby, for myself, my heirs, executors and administrators, hold harmless and release and forever discharge the, its Competition and District Directors, the Town of Melbourne Beach, FL, Brevard County, the State of Florida, and all ESA corporate and local sponsors, including but not limited to all ESA sponsors, supporters, affiliates, marketing, corporate, support and logistics partners and associates, and all officers, directors, employees, members, and agents of the foregoing and all other entities and/or persons furnishing labor, support or materials, whether compensated or not, and any officials, employees, agents and volunteers associated with this competition, from all liabilities for injuries and damages whatsoever, arising from my presence or participation in the above described event, and do hereby grant the sponsors such release as described herein. I further acknowledge and consent to the right of the ESA to utilize my image in all forms of media and grant permission to the ESA to do the same and to share, convey, transfer or assign such images as the ESA deems appropriate and upon such terms and conditions as the ESA deems appropriate. I acknowledge that I have read and understand all of the above. CONTESTANT NAME (Please Print): CONTESTANT SIGNATURE: DATE: FOR CONTESTANTS UNDER 18 YEARS OF AGE: NAME OF PARENT OR GUARDIAN (Please Print): SIGNATURE OF PARENT OR GUARDIAN: DATE: I HEREBY CERTIFY that I am the parent or legal guardian of the surfer named above, and do hereby give my permission without reservation and with full understanding and comprehension of the foregoing agreement to hold the aforementioned organization and governmental entities harmless any and all liabilities including any such injuries which are alleged to have occurred as a result of negligent failure of ESA officials, judges and directors to properly supervise contestants in the course of competition.

If your membership expires on or before September 30, 2019 you must renew your membership (Age as of January 1, 2020). Note: Divisions listed below are for the 2019 District season/2020 Championships. NEW & RENEWAL MEMBERSHIP APPLICATION Preferred method is online at http://esa.surfsignup.com/ Name: Date of Birth: Mailing Address: City: State: Zip: Phone: ( ) Email: District: MEMBERSHIP TYPE (check one): New Member Renewal Member Exp. Date SUPPORTING MEMBERSHIP $35 per person (non-competitive) COMPETITION MEMBERSHIP - $75 per person for all divisions based on age/gender FAMILY MEMBERSHIP - $150 total for three or more persons (individuals must reside at the same address) The cost includes all divisions available based on age/gender for competitive family members (list names, date of birth and divisions for each additional member on additional sheet). Shortboard Divisions Boys U12 (11 & Under) Boys U14 (13 & Under) Boys U16 (15 & Under) Junior Men U18 (17 & Under) Men (18-29) Masters (30-39) Senior Men (40-49) Legends (50 & Over) Grand Legends (60 & Over, M/F) Girls U12 (11 & Under) Girls U14 (13 & Under) Girls U16 (15 & Under) Junior Women U18 (17 & Under) Women (18-34) Ladies (35 & Over) Open Shortboard (All Ages, M/F) Longboard Divisions Menehune Longboard U14 (13 & Under, M/F) Junior Longboard U18 (17 & Under) Mens Longboard (18-34) Masters Longboard (35-49) Legends Longboard (50 & Over) Grand Legends Longboard (60 & Over, M/F) Junior Womens Longboard U18 (17 & Under) Womens Longboard (18-34) Ladies Longboard (35 & Over) Bodyboard Open Bodyboard (All Ages, M/F) SUP Open SUP (All Ages, M/F) As a member of ESA, you are eligible to receive a one-year subscription to Surfer Magazine for ONLY $5. Surfer is available in print and digital subscriptions (please specify below one per household). If you would like to receive this Surfer subscription, please include an ADDITIONAL $5 to your total payment and specify print or digital subscription. Print subscription Digital subscription Money Orders Only! No personal checks accepted! Please make your money order payable to ESA and mail to: TOTAL MEMBERSHIP FEES ENCLOSED: $ (Please be sure to include the $5 for Surfer Magazine subscription, if you choose to receive, in your total money order amount) For questions about your membership, please contact info@surfesa.org