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RETURN COMPLETED FORM
<br />AND PAY T T
<br />ICSC
<br />P.O. Box 26958
<br />New York, NY 10087-6958
<br />Fax: +1732 694 1800
<br />GOLF CONTACT
<br />Ryan Johnson
<br />Tel: +1214 560 3285
<br />E-mail: Ryan.johnson@srsre.com
<br />ICSC CONTACT
<br />Christabelle Flanhardt
<br />Tel: +1646 728 3638
<br />E-mail: cflanhardt@icsc.org
<br />WHEN
<br />Wednesday, November 6, 2013
<br />9:00 am Shotgun Start
<br />ERE
<br />Cowboys Golf Club
<br />1600 Fairway Drive
<br />Grapevine, TX 76051
<br />Golf 111'covirnanaent
<br />FEES
<br />$130 (non-refundable) per player via check made
<br />payable to ICSC. Fee includes practice, green fees,
<br />box lunch and cart rental. (Golf club rental extra.)
<br />Please Note: Space is limited to 100 players and will
<br />be confirmed on a first-come, first-served basis. Please
<br />pre -arrange your foursome t'R¢.r;.xtt ¢..rrerr'�dlrrrmlrr „yr�rrar'
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<br />PLATINUM SPONSORS
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<br />THE C (fNI�N(EI( T"N(Ifl
<br />WIFUNT
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<br />Name
<br />Company
<br />Address
<br />City
<br />State/Province
<br />Zip/Postal Code
<br />Telephone
<br />Fax
<br />E-mail
<br />Your ICSC Membership I.D.#
<br />❑ Please check here if any of the above information has recently changed.
<br />Method of payment
<br />❑ Check made payable to ICSC enclosed for $
<br />❑ MasterCard ❑ Visa
<br />❑ AMEX ❑ Discover $
<br />Name (as it appears on credit card)
<br />Credit Card Number (include all digits)
<br />Signature
<br />Expiration Date (month/year)
<br />2013TX-B
<br />Release of Claims (Read Carefully and Sign)
<br />I agree and acknowledge that I am participating in the ICSC Texas
<br />may sustain as a result of participating in any and all activities
<br />which may accrue to me or my heirs arising out of or in any way
<br />Conference and Deal Making Golf Tournament ("Sports Event") on
<br />connected with or associated with the Sports Event.
<br />connected with my participation in the Sports Event.
<br />my own accord. I give this acknowledgement freely and knowingly
<br />In consideration of the right to participate in the Sports Event, I
<br />I further agree to indemnify, defend, and hold harmless the
<br />and I represent and warrant to you that I am physically and mentally
<br />hereby waive any and all rights or claims I may have as a result of
<br />International Council of Shopping Centers, Cowboys Golf Club, and
<br />fit and that, as a result, able to participate, and I do hereby assume
<br />participation in the Sports Event against the International Council
<br />their respective directors, officers, employees, members, staff, and
<br />responsibility for my own well-being.
<br />of Shopping Centers, Cowboys Golf Club, and their respective
<br />all individuals assisting in instructing, sponsoring and conducting
<br />I am fully aware that possible physical injury might occur to me
<br />directors, officers, employees, members, staff, and all individuals
<br />these activities, from any and all claims resultingfrom injuries,
<br />as a result of my participation, and I agree to assume the full risk,
<br />assisting in instructing, sponsoring and conducting these activities,
<br />including death, damages, or loss, which may accrue to me or my
<br />including risk which is not specifically foreseeable, of any injuries,
<br />and I hereby fully release and discharge them from any and all
<br />heirs arising out of or in any way connected with my participation in
<br />including death, damages or loss regardless of severity, which I
<br />claims resultingfrom injuries, including death, damages or loss,
<br />the Sports Event.
<br />Signed
<br />Print Name
<br />Date
<br />4
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