CHAMBER OF COMMERCE

							                       CHAMBER OF COMMERCE
           2011 “CELEBRATION OF LIGHT” CHRISTMAS PARADE
                     DECEMBER 3, 2011 AT 6:00 P.M.
                          ENTRY FEE $15.00

                                                           DATE: _____________________

NAME OF ENTRY : ___________________________________________________________________

NAME OF SPONSORING ORGANIZATION: ______________________________________________

CONTACT PERSON: __________________________________________________________________

TELEPHONE NUMBER: (H) __________________________ (W) ______________________________

MAILING ADDRESS: __________________________________________________________________

EMAIL ADDRESS:____________________________________________________________________

                            ENTRY INFORMATION

TYPE:                       CLASSIFICATION:                       FEATURES:

FLOAT ____________________ SM. BUSINESS ____________________      MUSIC ______________

WALKING UNIT ____________ CORPORATION ___________________         PROP DESIGN ________

CAR _______________________ CHURCH _________________________      LIGHTS _____________

CARRIAGE _________________ SCHOOL _________________________       ADULTS ____________

OTHER ____________________ CIVIC CLUB ______________________      CHILDREN __________

PLEASE PROVIDE A DETAILED DESCRIPTION OF THE PARADE ENTRY:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
_______________________________________________________________________________

YOUR APPLICATION WILL NOT BE CONSIDERD UNLESS THE DESCRIPTION IS COMPLETED.
THE ENTRY MUST BE DESCRIBED OR IT WILL BE PULLED FROM THE PARADE. INCLUDE A
DESCRIPTION OF YOUR UNIT, INFORMATION CONCERNING THE SPONSORING
ORGANIZATION AND ANY OTHER FACTS YOU WOULD LIKE TO MENTION.

                             DEADLINE – December 1, 2011

                    PLEASE SIGN LIABILITY DISCLAIMER AND
                         MAIL TO THE ADDRESS BELOW:
               BAXLEY - APPLING COUNTY CHAMBER OF COMMERCE
                                 P. O. BOX 413
                            BAXLEY, GEORGIA 31515
                                  CHAMBER OF COMMERCE
                                   LIABILITY DISCLAIMER


The Baxley/Appling County Chamber of Commerce (BACCOC) does not provide liability
insurance for the protection of participants, spectators, merchants or others who participate in the
Christmas Parade and activities.

In consideration of being permitted to participate in such activity the participant does hereby
release and forever discharge the Baxley/Appling County Chamber of Commerce, its board of
directors and employees, jointly and separately from any and all actions, causes of action, claims
and demands for upon or by reason of any damage, loss or injury, consequence of participating in
the BACCOC parade activities.

This release extends and applies to, and also covers and includes, all unknown, unforeseen,
unanticipated and unsuspected injuries, damages, loss and liability, and the consequences thereof,
as well as those not disclosed and known to exist. The provisions of any state, federal, local or
territorial law and statute providing in substance that releases shall not extend to claims, demands,
injuries or damages which are unknown or unsuspected to the person executing such release at
the time of such execution, are hereby expressively waived.

I hereby agree on behalf of my heirs, executors, administrators, and assigns to indemnify the
BACCOC, its officers, officials and employees and all members and officials of the Christmas
Parade Committee, jointly and severally, and to hold the same harmless form and against any and
all actions, whatever kind or nature, including attorney fees, which may at any time be incurred
be them or claimed against them by reason of may participation in the Christmas Parade.

Candy, gifts, toys or any other items shall not be thrown, tossed or in any way given out during
the parade, due to the increased risks caused by such actions.

Name of Organization: ____________________________________________________

Date: ______________________ Participant: ________________________________

Parent must sign if participant is a minor: ______________________________________

Address: _______________________________________________________________

Telephone: ______________________________________________________________


LIABILITY DISCLAIMER MUST BE SIGNED BY EACH INDIVIDUAL IN THE
PARADE! THANK YOU!!