Insurance Waiver - Yakima's Fourth of July Celebration

Document Sample
Insurance Waiver - Yakima's Fourth of July Celebration Powered By Docstoc
					                             Liability Waiver

Name __________________________________________________ Age ___________
                                                                         (under 18 only)


Address ________________________________________________________________


City __________________________________________ State ____________________


Please check one:

________ Performer     ________Volunteer     ________ Non-Profit Vendor

Said participant hereby releases the Yakima Fourth of July Celebration Committee, its
officers, agents and volunteers, and the Board of the Yakima County Commissioners
from any liability from loss, damage or injury, to said participant or any member of the
participating team/volunteer group/vendor while on the grounds of the State Fair Park
(Central Washington State Fairgrounds) during the 2010 Yakima 4th of July Celebration.



Signature _______________________________________________________________


Signature of
Parent or Guardian ________________________________________________________
                                                   (under 18 only)

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:3
posted:3/31/2012
language:
pages:1
Lingjuan Ma Lingjuan Ma
About