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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

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