Participant's Name: ____________________________Craft:_______________________________

Applications must be received by September 7th, 2011. Return to: RLE Chamber or drop off at the Rio Linda News,
6808 Front Street, Rio Linda, Ca 95673. Email; LisaLMorris@comcast.net

*Cost-We are only asking for a Donation of $10 to the "Firehouse 111 Museum."  Please make checks payable to
"The Foundation for the Future," with notation "Firehouse 111 Museum Fund."

Agreement Waiver, & Release

I have carefully read the description of the event for which I/we are registering and in consideration for being permitted by The Rio Linda Elverta Chamber of Commerce to participate in the above activity, I hereby waive, release, and discharge any and all claims for damages for personal injury, death, or property damage which I may have, or which may hereafter accrue to me, as a result of participation in said activity. This release is intended to discharge in advance the Rio Linda Elverta Chamber of Commerce, its officers, officials, employees, and volunteers, any and all liability arising from or connected in any way with my participation in said activity, even though that liability may arise out of negligence or carelessness on the part of the persons or entities mentioned above. It is understood that this activity involves an element of risk and danger of accidents and knowing those risks, I hereby assume those risks. It is further agreed that this waiver, release and assumption of risk is binding to my heirs and assigns. I agree to indemnify and to hold the above persons or entities free and harmless from any loss, liability, damage, cost, or experience, which they may incur as the result of my death or injury, or property damage that may be sustained while participating in said activity. Furthermore, the undersigned allows any photos taken of participant or family members during participation in this event to be used in any future promotional materials produced by the Rio Linda Elverta Chamber. www.RLEChamber.org

Parental Consent: (to be completed and signed by parent/guardian if applicant is under 18 years of age)
I hereby consent that my daughter/son, ______________________________________________________________________________________
participate in the above activity, and I hereby execute the above Agreement, Waiver, and Release on his/her behalf. I state that said minor is physically able to participate in said activity. I hereby agree to indemnify and hold the persons and entities mentioned above free and harmless from any loss, liability, damage, cost, or expense which they may incur as a result of the death or injury or property damage that said minor may sustain while participating in said activity.

I HAVE CAREFULLY READ THIS AGREEMENT, WAIVER, AND RELEASE FORM AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN ME AND THE RIO LINDA ELVERTA CHAMBER OF COMMERCE AND I SIGN OF MY OWN FREE WILL.

Type of Craft or Vend: _______________________
Participant's Name: (print) _______________________
Participant's Signature: _______________________ Date: _______________________
Home Phone: _____________Work Phone: _________________ Cell: _______________________
Address: __________ City: ________________ Zip:_____________________
Email: ___________________________________________________________________________
Emergency Contact Person: _______________ Phone:_________________________