Permission Form 

for Minor Child Participation

Date/s: July 25, 26 & 27, 2008

Participants Name: _______________________________________ Age: ________

Home Address: ________________________________________________________

City: __________________ State: ________ Zip Code: _______________

Release:

I, the undersigned, hereby acknowledge that I am aware of and fully appreciate the nature of the premises of the above event, of the physical activity in which I have requested to be allowed to participate, and of the importance to comply with the requests made of me by the ranking participants.  I solemnly covenant and agree that if I am injured, I have thereby released or will without the tender of payment of any other or further consideration, whatsoever, release indemnity save and hold harmless from liability whatsoever any official associations, corporations, promoters or anyone involved in said event and thereby assume full and sole responsibility for the death or any injury of my person.  I have read the foregoing or it has been read to me, understood the same and agree to abide by all rules.  Failure to abide by the requests and rules of ranking participants may result in denial of my participation in the event activities, notification of my parent/s or guardian/s and/or removal from the event.

Participant’s Signature: ___________________________________ Date: ___________

Parent or Guardian Release:

For the consideration above I/we parent/s or legal guardian/s of the minor above consent to and approve his/her participation in the event and covenant contract and agree to indemnity save and hold any participant, association, corporation, promoters, or anyone involved in said event from any loss, cost, liability, expense, or responsibility whatsoever arising directly or indirectly out of any injury or death that said minor might sustain as a result of participating in the event.  I understand if contacted in regards to misconduct of said minor, I will be responsible to accompany him at the event or arrange for transportation from the event.

Parent or Legal Guardian Signature: __________________________

Relationship: __________________Date: ___________________

Witness: ___________________________________________ Date: ________________