VIEWS: 5 PAGES: 2 POSTED ON: 2/12/2012
2012 Sponsorship/Membership Rates: (Please circle one) 2012 Membership Large Business Sponsor $100 for the DFA Small Business Sponsor $25 Single membership $15 Two memberships $25 If you own a business… a general membership level may not quite fit your needs. Please see the sponsorship 3 or more memberships $30 table for more options available to businesses. Please indicate which level you are choosing when you fill out this form. Combined memberships must be from the same household. Name: _______________________ Age :_______ DFA Office Use Name: _______________________ Age :_______ Amount Rec’d ___________ Rec’d by: _______________ Name: _______________________ Age :_______ Rcd by Treas. ____________ Name: _______________________ Age :_______ Rec. in yrly db____________ Checked in mstr db _______ Name: _______________________ Age :_______ Checked/added in e-mail account ________________ Name: _______________________ Age :_______ Head of Household Name: _____________________________ YES, I would like to volun- teer to help at an event Mailing Address: _____________________________ ____________________ _____________________________ YES, please add me to your mailing list to receive up- Phone Number: _____________________________ dates by mail or e-mail. NO, I do not wish to receive E-mail Address: _____________________________ any mailings. DFA Waiver, Release and Indemnity Agreement The undersigned individual for himself or herself, his or her spouse and/or his or her children or ward, and their heirs, next of kin, executors, representatives, administrators, successors, and assigns (hereinafter collectively and individually referred to as the “Undersigned”) who participate in Dirt Floor Arena (DFA) sponsored activities, events or programs at the Dirt Floor Arena Complex located at the Duluth/Proctor Fairgrounds, Municipalities, Counties, or other local governments in or through which the Event takes place or is conducted, agree to indemnify, save and hold harmless any person, volunteer, entity or sponsor connected with the Event, and their respective officers, directors, agents, employees and volunteers, and their heirs, next of kin, executors, representatives, administrators, successors, and assigns (hereinafter collectively referred to as the “Released Parties”). The Undersigned does hereby voluntarily and forever waive, release and discharge the Released Parties from any and all claims, actions, and/or liability of any type or kind (including, but not limited to, damages for personal injury) that the goods, services, participation, instruction in any way, or anything else connected with the Event, by or as a result of any action or inaction of the Released Parties, or other acts or omissions of any type or kind relating to the Event, regardless of wherever the Event is held. The Undersigned fully understands, acknowledges and agrees that by participating in the Event, there is a probability of accidental or other physical injury or death. Nonetheless, the Undersigned further agrees to assume the risk of personal injury or death, and any and all other risk or any loss or injury of any type or kind whatsoever to Undersigned, Undersigned’s livestock or injury or loss by Undersigned to other livestock, including loss of use and any other indirect or consequential damages which the un- dersigned may suffer, resulting directly or indirectly, wholly or in part, from the Event, and further agrees to indemnify and hold harmless the Released Parties from any and all loss, cost or expense suffered, and claims, demands, actions, damages and judgments of any nature asserted against the Released Parties as a result of the Undersigned’s participation in the Event. Under Minn. Stat. § 604A.12, the sponsor(s) of livestock activities are not liable for the injury or death of a participant, or a spectator in an unau- thorized area arising from the inherent risk of livestock activities. Inherent risk means the dangers arising from the propensity of livestock to behave in unpredictable ways, including kicking, biting, spooking in response to sound, sudden movement, unfamiliar objects, persons and other animals. In the event any provision of this Waiver, Release and Indemnity Agreement is found invalid or unenforceable by a court of competent jurisdiction, the remaining provisions shall not be affected thereby and shall be enforced to the extent permitted by law. The Undersigned has read and understands this Waiver, Release and Indemnity Agreement and by signing below, the Undersigned consents for Undersigned and/or Undersigned’s household members to participate as DFA Member(s). All household members from Undersigned’s household are informed of the DFA Waiver, Release and Indemnity Agree- ment and agree to comply. Only Parent &/or Legal Guardian may sign this form on behalf of entrants 17 & under. Complete and return to: Participant Signature _______________________________ PO Box 1006 Parent/Guardian Sig. _______________________________ Duluth, MN 55810 (if necessary) Date _______________________________ 2012 Sponsorship of the DFA Large Small Member *In- Business Business Level Kind Level Level $100 $50 $30, $25, Any or $15 Media Recognition in official DFA newsletter & on website. x x x 1 year business hyperlink on the DFA web site. x x 1 year display ad on our website Full Page Business Card Dirt Floor Arena Sponsored Events Opportunity to post advertising leaflets* at all DFA events. x x x x Opportunity to distribute promotional materials*. x 1 year display of a maximum 4’ x 8’ sign* in our indoor x arena** 1 year display of a framed 8” x 10” sign* in our indoor x x arena with business cards Other 1 year membership to the DFA 1 1 * In-Kind—donation of service or goods ** DFA Board of Directors will approve all signs and postings *** Design and creation of indoor signs via a third party will be the responsibility of the sponsor. Contact the DFA for assistance.
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