Woodland Planter's Day Bed Race - Entry Form

TEAM NAME:___________________________________________________

CAPTAIN/CONTACT NAME:_________________________________________

ADDRESS:__________________________________________________

CITY:_____________________________________________________

STATE:____________________________________________________

ZIP:_______________________________________________________

PHONE #1:_______________________________________________

PHONE #2:_______________________________________________

E-MAIL ADDRESS:___________________________________________

SECONDARY CONTACT NAME:_________________________________________

PHONE #:_______________________________________________

E-MAIL ADDRESS:___________________________________________


Return entry form via US mail to:
Planters Days Bed Race
PO Box 160
Woodland, WA 98674


Or

Return entry form via E-mail to: mikegolik@yahoo.com

Or

Return entry form via fax to: 360-225-6881



WOODLAND PLANTERS DAYS BED RACE WAIVER OF LIABILITY

THIS MUST BE SIGNED BY ALL THOSE PARTICIPATING IN THE EVENT AND RETURNED TO BED RACE OFFICIALS THE DAY OF THE RACE.

IN CONSIDERATION OF THE ACCEPTANCE OF MY APPLICATION / ENTRY FORM FOR THE WOODLAND PLANTERS DAYS BED RACE, I HEREBY RELEASE ALL ASSOCIATED GROUPS; WOODLAND TRUE VALUE, THE WOODLAND PLANTERS DAYS COMMITTEE, THE CITY OF WOODLAND WASHINGTON, AND ANY PERSON OFFICIALLY OR UNOFFICIALLY CONNECTED WITH THIS COMPETITION, FROM ALL LIABILITY FOR ANY INJURIES OR DAMAGES WHATSOEVER ARISING FROM THIS COMPETITION EVENT.

PLEASE INDICATE YOUR CAPTAIN WITH A STAR (*).

PARTICIPANT #1:________________________________________DATE:________________

PARTICIPANT #2:________________________________________DATE:________________

PARTICIPANT #3:________________________________________DATE:________________

PARTICIPANT #4:________________________________________DATE:________________

PARTICIPANT #5:________________________________________DATE:________________

THIS WAIVER MUST BE TURNED IN TO BED RACE OFFICIALS THE DAY OF THE RACE.

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