FEES  

INDIVIDUAL & GROUPS $10:00 

CHILDREN (UNDER 12) FREE
ALL POLITICAL ENTRIES $35.00
  REGISTRATION FORM  
Please fill out the form and send with a check or money order to:
AMBOY TERRITORIAL DAYS COMMITTEE PARADE
PO BOX 203
AMBOY, WA 98601		 FOR QUESTIONS, PHONE: 
TERRITORIAL DAYS COMMITTEE
PARADE CHAIRPERSON
247-5312
NANCY BUCKBEE
A SIGNED REGISTRATION FORM IS REQUIRED FOR EVERY ENTRY

 
NAME OF ENTRANT ____________________________________________________
    OR ORGANIZATION
CONTACT PERSON _____________________________________________________
IF DIFFERENT THAN ENTRANT
 

ADDRESS ______________________________________________________________

 
CITY ____________________________________________ STATE _____ ZIP ______

 
PHONE ____________________________  FAX / CELL _______________________

 
CATEGORY NO. ____________________
FROM PREVIOUS PAGE		 LENGTH OF ENTRY (IN FEET) _____
 

DESCRIPTION _________________________________________________________
 

ADDITIONAL INFORMATION ____________________________________________

_______________________________________________________________________
In consideration of your accepting my entry in the Amboy Territorial Days Parade, I hereby waive release and discharge the Territorial Day's committee and it's Sponsors from any and all liability from injury, illness, or damages I may occur as a consequence of participation in this event. I authorize the Sponsors of the event to use my name and pictures of me without obligation or liability to me. This release and waiver of liability also shall be binding on my heirs, executors and administrators. My participation in this event is purely voluntary and not related in anyway to my employment of any member of my family. The Organizational Representative named here as participant in the Territorial Days Parade, warrants that he/she is empowered to sign for the applying entrant.

SIGNED___________________________________________________________

DATE    _____-_____-_____