Corn Cob Regatta Registration Form

Name:

Mailing Address:

City:                                                State:                Zip:

 E-Mail

Are You 14 or older YES      NO

(You must be over 14 or accompanied by an adult) _____

* * * THE CORN COB REGATTA  * * *

RELEASE FORM

THE UNDERSIGNED, PARTICIPATING IN THE CORN COB REGATTA:

1. Fully recognizes and accepts the responsibility for any and all risks and hazards involved in such an activity.
2. Agrees to use a life jacket.
3. Willing to incur all responsibility for claims and personal injury and/or property damages to him or herself or fellow participants or spectators which might result from his or her negligence.
4. Waiving all rights and claims against the sponsors, its Officers and Members of the volunteer corn Cob Regatta, jointly and individually.
5. Subject to revocation of the registration and forfeiture of the entry fee if, in the opinion of the Committee, there is misconduct, misuse or nuisance on the undersigned's (one or all) part.
6. This form must be turned to the Committee prior to the start of the regatta. No person will participate in the Corn Cob Regatta without this release.

NAME (please print) ___________________________

SIGNATURE ___________________________________________

Minors must have a guardian sign with them.

Date