Madison 2008 RibberFest Kidz “Q” Application

Contact Information

Child’s Name

Parent/Guardian’s Name

Parent’s Address

City ST ZIP Code

Home Phone

Cell Phone

E-Mail Address

Age Group

Ages 8 - 11

Ages 12 - 15

Agreement and Signature of Parent

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if the child listed above is accepted as a participant, any false statements, omissions, or other misrepresentations made by me on this application may result in his/her immediate dismissal. 

Waiver of Liability: In consideration of accepting this entry.  I, the undersigned, intending to be legally bound, hereby for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages against the Madison RibberFest, and their agents, successors, and assignee, for any and all injuries suffered in this event.  Further, I hereby grant full permission to the Madison RibberFest and/or agents authorized by them, to use any photographs, videotapes, motion pictures, recordings and any other record of this event for any legitimate purpose.

Name of Guardian (printed)

Signature                                                                                   Date

Entrance fee paid:                                                                       Date