Pet Show – Registration Form Name Pet Name _One pet per form

Document Sample
Pet Show – Registration Form Name Pet Name _One pet per form Powered By Docstoc
					                                           Pet Show – Registration Form
Name: _________________________________   Pet Name: ________________________________
                                          (One pet per form)
Address: ___________________________________________________________________________

Email: _____________________________________________________________________________

_____________________________________________________________________________

Check which categories you are entering:

____ Best Tail Wag                 ____ Most Closely Resembling Owner                                      ____ People’s Choice Award

____ Best Costume                  ____ Most Mysterious Heritage                                           ____ Best Photo – Online*
                                                                                                           (Must register by Sunday 10/16/11)


_______________________________________________________________________________________

Payment:

           Blue Ribbon Club - $25 donation                                                                             $_____________
                       Enter as many categories as you wish.
                       All proceeds support Grace Relay For Life Team.
OR
           Individual Categories, $5 donation each                                                                     $_____________
                       Calculate no. of categories _______ x $5 each =

                                               Additional Contribution:                                                $______________

                                               TOTAL AMOUNT PAID:                                                      $______________


Pay By: _____ Cash                             _____ Check (payable to Grace UMC, memo line: Relay For Life)

                       (Mail checks and form to: Grace UMC, Attn: Pet Show, 2113 Old Monrovia Rd., Huntsville, AL 35806)

RELEASE AND INDEMNITY AGREEMENT — PLEASE READ AND AGREE BEFORE SIGNING
In consideration of being permitted to participate in the Grace UMC Pet Show, I acknowledge that I assume full responsibility for my safety and the safety of my pet. I further
understand that I am participating iat my own risk and I agree to release, waive, and hold harmless Grace United Methodist Church, its officers, directors, agents, legal
representatives, volunteers, members, servants, and each of them (hereinafter referred to as "Releases") from any and all liability to me, my spouse, legal representative and /
or heirs and assigns, for any and all loss, personal injury or damage, and any claim or damages resulting therefrom on account of injury to my person or property, whether
caused by the negligence of Releases or otherwise while participating in the Grace UMC Pet Show.

I agree that this release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State of Alabama, and that if any portion
hereof is later found to be invalid or unenforceable, it is agreed that the balance of this agreement shall notwithstanding, continue in full legal force and effect.

I further agree that in consideration of being permitted to participate in the Pet Show, I consent to be photographed and release Grace UMC to use a likeness of myself and my
pet to be used in promotional advertising for future events. I understand that Grace UMC has the right to refuse any entry, to limit the number of contestants or to divide any
class.


_______________________________________________________                                                                _____________________
Signature (if under 18 years of age, signature of parent or guardian)                                                   Date

				
DOCUMENT INFO
Categories:
Tags:
Stats:
views:6
posted:3/7/2012
language:Latin
pages:1