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Parent/Guardian:
Name: _________________________________
Phone: _________________________________
Waiver and Release: Please read prior to signing entry form.
I hereby request permission to participate in the Turkey Hill Country Classic Baby Derby. In consideration of the entry being accepted, I, intending to be legally bound for myself, my heirs, executors, administrators, waive and release any and all rights I have against the organization holding this event, its agents, representatives, sponsors, successors and assigns for any and all injuries suffered by me or damages out of, or related to, the event. I grant permission to use photos of me and release my name for any and all event purposes. All of the forgoing has been read by the undersigned and voluntarily been signed.
Signature: __________________________ Date: ____________
(Parent/Guardian must sign)
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