ENTRY AND LIABILITY RELEASE FORM
SALSA EATING CONTEST

Name:_______________________________________________

Address:_____________________________________________

Street / PO Box________________________________________

City /  State  / Zip code__________________________________

AGE:__________________Phone#_______________________

Entry fee $5.00

In consideration for being accepted by the Salsa Festival for participation in the Salsa Eating Contest I do hereby release, forever discharge and agree to hold harmless the Salsa Festival and the directors thereof from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the participant that occur while said person is participating in the above-described event or activity including recreation and work activities.  The undersigned further agrees to hold harmless and indemnify said Festival, its directors, employees and agents for any liability sustained by said participant, including expenses incurred attendant thereto.

The undersigned further consents to the administration of first-aid and/or doctor's care, or any other form of medical treatment necessitated by illness or injury that may require the same.  In the event of the necessity of such care or treatment as heretofore described, the undersigned agrees to hold harmless and indemnify said festival, its directors, employees and agents from any acts of malfeasance, and/or failure to act on the part of those chosen to administer medical care on behalf of the participant.

Signature of Participant__________________________________

Signed this __________ day of ____________________, 2008.