EVENT APPLICATION
EVENT APPLICATION FORM
Date of Event _________________
Participant’s Name______________
Address_______________________
_____________________________
Home Phone____________________
Emergency Contact
Name ____________
Phone____________
E-Mail Contact___________________
Age of Participant: ______
Food Allergies: ___________________
Applications will be accepted
until enrollment is filled
WAIVER AND RELEASE OF LIABILITY
I hereby confirm participant is in good health and able to participate in the activity. I acknowledge the activity may involve risk and danger of bodily injury or death. I fully accept and acknowledge the activities may involve risk, and I hereby assume the risk and responsibility for all dangers and risk associated with the activity.
I acknowledge W&J Artisans and their respective employees, directors, officers, volunteers, members and any other participant, entity, party or person involved in any regard with the activity or the activity premises and their respective agents, personal representatives, heirs employees, contractors, successors, and assigns (each on “activity representative” and collectively the “activity representatives”), shall not be responsible or liable in any regard or manner for any and all property damage or bodily injury (including serious physical injury or even death) incurred by participant or any party related thereto as a result of his/her participation in the activity.
I have read, fully understand, and hereby freely sign, approve of, and agree to the terms of the registration form. I hereby unconditionally release, discharge, covenant not to sue, waive my rights and remedies and agree to hold harmless the activity representatives from any and all claims, costs, demands, losses, damages, or expenses associated with, in whole or in part, participants involvement with the activity. I certify all answers and information provided on this registration form are to the best of my knowledge true and correct throughout the activity. I shall inform the business in writing if any information provided in this registration form is incorrect or changes through the course of the activity. I understand W&J Artisans does not perform criminal and/or background checks on activity representatives. I shall present a government-issued photo identification card including, but not limited to, my driver’s license, passport, or United States Visa to the activity representatives for review, if requested, at the time I submit this registration form to W&J Artisans.
Signature
Signature of Participant (if over 18)_________________________
OR of parent/guardian (if under 18): ___________________________
Date Signed: _______________
Print Name of Signatory: __________________
Relationship to Participant: ________________
No product