2012 membership by wuzhengqin


									                                                                                                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


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

1 year display of a framed 8” x 10” sign* in our indoor                                  x                     x
arena with business cards


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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