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BUCKEYE WOODCARVERS ROUNDUP

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BUCKEYE WOODCARVERS ROUNDUP

 

     In consideration of my acceptance as participant in the Woodcarving Classes, I do hereby, my heirs, executors, and administrators voluntarily assume all risks whether foreseen or unforeseen and waive, release and forever discharge any and all rights and claims for damage which I have or which may arise to me against BUCKEYE WOODCARVERS ROUNDUP or POOR FARMER'S CAMPGROUND,  and volunteer helpers for any and all damages to persons or property which may be sustained or suffered by me regardless of negligence in connection with my said association with, or entry into, said class and arising out of my traveling to, participation in, and return from class.   (If participant is under 18 years of age, their guardian or parent has to sign for them.)

  I further state that I understand this release form and have signed this document voluntarily this___________day of_____________________.

SIGNATURE_________________________________________________________________________________

PRINT NAME_________________________________________________________________________________

RELATIONSHIP (IF under 18 years of age)___________________________________________________________

ADDRESS___________________________________________________________________________________

CITY, STATE, & ZIP___________________________________________________________________________

TELEPHONE NUMBER________________________________________________________________________

E-MAIL ADDRESS___________________________________________________________________________

IN CASE OF EMERGENCY CONTACT____________________________________________________________________________________________

MAIL to: BUCKEYE WOODCARVERS ROUNDUP  with PRE-REGISTRATION FEE ($15.00 PER PERSON) BEFORE JUNE 30, 2017 to:      JIM FOSTER,   211 E. ASH ST.,   PIQUA, OH 45356

 

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