PARTICIPANT INFORMATION:

I understand that my participation in the Musical Midway Charity All-Nighter requires compliance with specific regulations for this Event. I agree to abide by all rules and regulations set forth. Any infraction of the rules or regulations, including, but not limited to, the possession of alcohol, drugs, or weapons will cause my dismissal from the Event. If I should be dismissed, I understand that my emergency contact listed below will be contacted to arrange for my immediate transportation from the Event.

I hereby agree to grant the full rights to my images to the WMCD, Inc for re-use and publish photographs or composites with my image without restriction. I waive any further rights to approve any future use. 

I understand that the Charity All-Nighter is a 25-hour event in which I (or my dependent) will be asked to dance, with loud music and/or strobe lights, and that prolonged dancing and/or standing and such related activities carry with them certain inherent dangers. I certify that I (or my dependent) am physically fit and adequately prepared to participate in this Event. In the event of an emergency, I hereby grant permission to treat illness and/or injuries on site and to transport me (or my dependent) and obtain emergency medical or surgical treatment(s) from a licensed physician, hospital, or medical clinic. I hereby authorize medical personnel to release necessary information about me (or my dependent) care to WMCD, Inc.

I am of full legal age and understand the terms of this release. By signing here, I agree to the above. Or As the legal guardian of the registrant, I understand the terms of this release. By signing here I agree to the above.

MEDICAL INFORMATION:

PARENT/LEGAL GUARDIAN INFORMATION:

I understand that my child's participation in the Musical Midway Charity All-Nighter requires compliance with specific regulations for this Event as described above and in subsequent communications sent to the attached email. Specific issues may be announced as required at the event.

I agree on behalf of the Participant to protect, defend, hold harmless, and fully indemnify WMCD and the hosting facility for any claim or cause of action whatsoever relating to or arising out of the participation of the Participant in this Event that may be brought against the Releases, or any one of them, by any person, or entity, including without limitation, the Participant or his/her family members.

By signing below, I give permission for Participant mentioned above to participate in the Musical Midway Charity All-Nighter.



$0.00
$0.00

PAYMENT HERE

  • Visa
  • Mastercard
  • American Express
  • Discover
RegFox Event Registration Software