Krazy for the Kazoo Registration Form


Registrant

T-shirt size:
Glove size:

If you are affiliated with a group, what is the group name?

Other Members/Family

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Glove size:
T-shirt size:
Glove size:
T-shirt size:
Glove size:
T-shirt size:
Glove size:

Names of Minor/s

T-shirt size:
Glove size:
T-shirt size:
Glove size:
T-shirt size:
Glove size:
T-shirt size:
Glove size:

How did you hear about this event? (Please check all that apply.)

If you selected other, please enter how you heard about the event:

Please check the boxes of ALL tasks you are interested in helping with: (check all that apply)

Please check site conditions you are willing to work in: (check all that apply)

Please list anything else we should be made aware of:

 

RELEASE OF CLAIMS WAIVER FORM

I fully understand that by signing this liability disclaimer, I, on behalf of myself and my agents, my group members, heirs and next of kin, assume all risks and hazards incidental to my participation in this activity, including transportation to and from these activities. I do hereby waive, release, absolve, indemnify, and agree to hold harmless, collectively, and individually, the City of Battle Creek, and Calhoun County from any claim arising from sickness, injury or death to me or my property except if caused by their gross negligence or willful and wanton misconduct.

I agree that if the City of Battle Creek, and Calhoun County are sued by anyone else because of claimed conduct of myself, I will indemnify the City of Battle Creek, the City of Springfield, and Calhoun County for all damages and costs, including attorney’s fees.

IN CASE OF EMERGENCY PLEASE CONTACT:

Name:

Phone:

I HAVE READ AND UNDERSTAND THE AGREEMENT:

Date:

 

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Signature Certificate
Document name: Krazy for the Kazoo Registration Form
lock iconUnique Document ID: c629eda98b3209c6581e5c19c916e7d00a0000a1
Timestamp Audit
August 12, 2021 8:43 pm EDTKrazy for the Kazoo Registration Form Uploaded by Bessie Ploeg - beploeg@battlecreekmi.gov IP 23.28.246.223
August 13, 2021 2:31 pm EDT Document owner denise@greenstreetmkg.com has handed over this document to beploeg@battlecreekmi.gov 2021-08-13 14:31:30 - 69.47.18.147