Name
*
First Name
Last Name
Street Address
*
City, State, Zip
*
Mobile Phone Number
*
(###)
###
####
Email
*
Gender
*
Date of Birth
*
MM
DD
YYYY
Age as of 12/31/25
*
Skill Level
*
At the Tournament Directors’ discretion, brackets may be adjusted. Registering for this tournament means you accept that this may happen. This is your notification that you may be merged with younger players. The 60+ brackets will be combined by age first, then skill. Medals will be given to all skill level brackets, even if combined.
Age Group
*
At the Tournament Directors’ discretion, brackets may be adjusted. Registering for this tournament means you accept that this may happen. This is your notification that you may be merged with younger players. The 60+ brackets will be combined by age first, then skill. Medals will be given to all skill level brackets, even if combined.
Event in which you will be replacing another player
*
The name of the player you are replacing
*
Remember: when you arrive at Check In, go to the table for the last name of the player that you will be replacing.
First Name
Last Name
Your partner's name
First Name
Last Name
Emergency Contact
*
First Name
Last Name
Relationship
*
Emergency Contact Mobile Phone
*
(###)
###
####
Do you currently have a profile on pickleballbrackets.com?
*
We will be using Pickleball Brackets as our tournament software for brackets, scoring and results.
If yes, what email address is associated with your pickleballbrackets.com profile?
How did you hear about Pickleball Against Poverty?
*
Word of mouth
pickleballtournaments.com
USA Pickleball Association
Pickleball Den
Total Turf
Social Media
Other
Other
RELEASE, PERMISSION, AND INDEMNITY AGREEMENT
*
South Jersey Dream Center Waiver Release. In consideration of being permitted to participate in any way in the Pickleball Against Poverty Tournament (“the Event”), I, for myself, my heirs or assigns, hereby release, waive, discharge and covenant not to sue South Jersey Dream Center Inc. as well as their officers, employees and agents from liability from any and all claims resulting in personal injuries, death, accidents, illnesses (such as communicable diseases including COVID-19), and property loss arising from, but not limited to, participation in the Event. Assumption of Risk. Participation in the Event carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks vary but include 1) minor injuries such as bruises, sprains and dehydration, 2) major injuries such as eye injuries, joint or back injuries, heat stroke, heart attacks, and concussions, and 3) catastrophic injuries such as paralysis and death. I have read the previous paragraphs and I know, understand and appreciate these and other risks that are inherent in playing pickleball. I assert that my participation is voluntary and that I knowingly assume all such risks. Indemnification and Hold Harmless. I also agree to indemnify and hold South Jersey Dream Center Inc. and all named above harmless from any and all claims, actions, suits, costs, expenses, damages and liabilities, including attorney’s fees brought as a result of my involvement in the Event. Use Permission. I also give South Jersey Dream Center Inc. and its agents and designees permission to use or distribute, without limitation or obligation, my image, name, voice, and words for any purpose connected with the Event, including promotional, marketing, training, informational, and archival uses. Players Courtyard Waiver: In consideration of being allowed to participate in any way in the Players Courtyard Pickleball Club, its related events and activities, the undersigned Participant: 1. Acknowledges that he/she is of legal age and capable to read, understand, consent to, and sign the waivers set forth in this form. 2. Acknowledges and fully understands that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, which might result not only from their own actions, inactions, or negligence but the actions, inactions or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Participant acknowledges that objects and obstructions exist within the play areas of the facility, and COLLIDING WITH WALLS, FENCES, AND OTHER OBJECTS AND OBSTRUCTIONS CAN AND WILL CAUSE SERIOUS INJURY. Participant nonetheless agrees to participate in Activities at their own and sole risk. 3. Assumes all the foregoing risk and accepts personal responsibility for the damages following such injury, permanent disability, or death. Play is at Participant’s own and sole risk. 4. Agrees to release, waive, discharge and covenant not to sue Players Courtyard Pickleball Club, its affiliated clubs, their respective administrators, directors, agents, coaches, and all other employees of the organization, other participants, sponsoring agencies, owners and lessors of premises used to conduct the event, all of which are hereinafter referred to as “Releasees”, from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the Releasee or otherwise. 5. Agrees and allows the use of photography during all activities, games, practices, events held at Players Courtyard Pickleball Club for promotional and other purposes. 6. Specifically regarding use of The Training Center at Players Courtyard Pickleball Club, Participant acknowledges and understands that the Training Center is NOT DESIGNED OR APPROPRIATE FOR ACTIVE, COMPETITIVE PLAY. OUT-OF-BOUNDS AREAS ARE NARROW AND CLOSE TO WALLS, AND COLLIDING WITH WALLS CAN AND WILL CAUSE SERIOUS INJURY. PLAY IS ONLY ALLOWED WITHIN THE SIDELINES AND BASELINES OF EACH COURT. ATTEMPTING TO MAKE A SHOT OUTSIDE OF ANY SIDELINE OR BASELINE CAN CAUSE SERIOUS INJURY TO PARTICIPANT. PARTICIPANT AGREES TO ABIDE BY THESE RULES, AND PLAYS SOLELY AT THEIR OWN RISK. I HEREBY KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, and assume full responsibility for my participation; and, I willingly agree to comply with the stated and customary terms and conditions for participation with regard to protection against injury. If I observe any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest staff member immediately. I HAVE READ THE ABOVE WAIVER AND RELEASE, AND SIGN IT VOLUNTARILY KNOWING AND UNDERSTANDING THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT.
