Southport Chapter: Troop Sign Up

If you are ACTIVE DUTY MILITARY, GUARD or RESERVISTS and would like to participate in MAD 2022 Southport, please complete this form in its entirety. You will receive a confirmation email shortly after your form has been submitted.
We encourage you to bring your families to enjoy our family activities while you are out fishing and then join you at the picnic.

Liability Release Waiver:
By submitting my form, I, in consideration of our ability to participate in the activities and events described herein and other good and valuable consideration, the receipt of which is hereby acknowledged, do hereby fully and unconditionally release and forever discharge any and all parties associated with the planning and implementation of events and activities for the Military Appreciation Day events in 2022, organized by members and volunteers of Military Appreciation Day, Inc, from any and all claims, losses, liabilities, demands, actions, or causes of action of any kind or character (including, without limitation, for attorney fees, costs and expenses), whether known or unknown, with knowledge that such may exist, whether at law or in equity, whether in contract, tort, or under statute, whether for personal injury, property damage, or other economic loss, emotional distress, punitive damage, or otherwise, that I now have against them or that might mature or accrue subsequent to the date of this Release, on account of, connected with, or growing out of the following matters or things:

Participation in or being present during any activity, event, function, gathering, meeting or other association during the Military Appreciation Day events in 2022. The “parties” held harmless under this Release shall be construed in the broadest application possible.

These parties are to include, but not be limited to, Military Appreciation Day, Inc., a non-profit corporation, and it’s members, volunteers and donors, vendors, suppliers, property owners, volunteers, coordinators, donors, supporters etc. Parties shall include individuals, corporations, limited liability companies, partnerships, organizations, associations, and any other forms of entity.

I hereby understand and agree that by submitting this form, this Release shall be binding upon me, my executors, administrators, personal representatives, collectors, heirs, successors, and assigns.

If you want to be assigned to the same boat as a friend please make sure they also sign up using this page and you need to make that request in the comments area below. Please note we try to accommodate all such requests but are limited based on the capacity of each vessel so we can not guarantee all such requests can be filled.
Contact Information
First Name:
Last Name:
Military Branch:
Email Address:
Confirm Email:
Day Phone:
Evening Phone:
Cell Phone:
Best way to reach you:
Emergency Contact Information
(for the day of the event)
Phone Number:
Number of people attending the cookout (including yourself)
If your family will attend, please list childrens ages in the comments section below. And may we please get your spouse info.
Your Spouse Name:
Your Spouse Phone Number:
For access to your registration confirmation and boat assignment information,
enter a password

By clicking the Submit button, you confirm Acceptance of the terms and conditions
of the Liability Release Waiver duly posted at the top of this page.

If you are a human DON'T enter anything here: