NHK Roundup

6. Registration Form

 

NHK 2016 Woodcarver's Roundup – 15/5/16

REGISTRATION

Waiver/Release

(available from release of list of Instructors till 31/3/16)



Print name: ____________________ Date ____________


Choice of Instructor (please indicate instructor #) 1st __________ 2nd ____________ 3rd __________


E-mail ______________________________ Tel. # _________________


Carving club (s) if applicable________________________


As an attendee I hereby agree, that I am aware of all risks associated with activities affiliated with this Roundup, and in consideration of participation in such an event and related activities do hereby release (for themselves, their heirs and any personal representative) and quit claim, discharge and waive any and all claims for death , personal injury, property damage, all liabilities, losses, damages, costs, expenses, causes of action, suits, and judgments which they or their representatives may have against, arising out of or in any way related to their participation in this Roundup, and also agree to indemnify those volunteers and instructors that assist in the running of this Roundup, harmless from any and all claims for death, personal injury or property damage arising out of, or in any way related to participation in this Roundup

By signing this document, I do hereby acknowledge that I have read, understood, and fully agree to the terms and conditions as stated.

 

Sign by: _________________________________________

(signature)


Please mail Completed form to -

Check payable to.

John H. Poole

28 Appaloosa Trail,

Carlisle, On, L0R 1H3

John H. Poole


For information E-mail ppoole3@cogeco.ca