EmailMe Form - Photography Entry Form

Exhibitor Name *

Age (Junior/Teen Events)

Address *

Street Address City State / Province / Region Postal / Zip Code

Phone

Email *

Photography Nominations

	Entry 1	Entry 2	Entry 3	Entry 4
Section
Class
Exhibit No.
Description of Entry

In this Waiver, Release and Acknowledgement Form “The Pioneer Valley Agricultural Show Society” means and includes all affiliated entities; servants or agents of the Society, all employees of the Society, all members of the Society and all Volunteers of the Society and/or all affiliated entities.

Waiver, Release and Acknowledgement *

I acknowledge that I have read this waiver fully and understand it's terms and that I have give up substantial rights signing it.

I have agreed to these freely and voluntarily without any inducement made to me and intent this to be a complete and unconditional release of all liability to the greatest extent allowed by law.

By exhibiting in the Show:

1. I acknowledge that it is a condition of participating in the Event that I do so at my own risk. I accept all risks and release the Society from all claims, demands and proceedings arising out of or connected with my participation in the Event and indemnify them against all liability for any injury, loss or damage arising out of or connected with my participation in the event. This release continues forever and binds all of my heirs, successors, executors, personal representatives and assigns.

2. I acknowledge that it is a condition of exhibiting in the Show that the Society and any person or body directly or indirectly associated with the Show are absolved from all liability arising for injury or damage to myself or my property howsoever caused arising out of my exhibiting in the Show.

3. I acknowledge that the Society relies on the information provided by me and state that all such information is accurate and complete.

Declaration of Minors - Under 18 Years of Age

If you are under the age of 18 years on the Event Day your parent/guardian must approve this declaration.

Minor's Full Name

Minor's Date of Birth

DD / MM / YYYY

Parent/Guardian Full Name

Checkbox

I certify that I am the parent/guardian/teacher of this minor and that he/she has trained for and has my consent to participate in the Event.

I testify that I have read the above and acknowledge acceptance of the stated conditions on behalf of the minor speciﬁed above.

Online nominations will not be accepted until entry fees have been received.

Pioneer Valley Agricultural Show
BSB: 064707
A/C Number: 00919932
Ref: Surname and section e.g. Smith, Craft