2010 Kidz Que Application

The Great American Barbecue
2010 Kidz Que Application
Deadline: April 16, 2010

Child's Name * First Last
Child's Age (on contest date) *
Parent's Name * First Last
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Daytime Phone * - (###) - ### ####
Evening Phone - (###) - ### ####
Email
Fees (one entry form per child)
Additional Wristbands ($8 each)
By Clicking the submit button, you are agreeing to the following conditions. In consideration of your 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 and/or loss I may have against the 25 to 1 Fund, The Great American Barbecue Contest, the Kansas City Barbecue Society, The Greater Kansas City Community Foundation, Wyandotte County Parks and Recreation, the Unified Government of Wyandotte County and New West Productions, their representatives, successors, and assigns for any and all injuries suffered by me in this event. Further, I hereby grant full permission to the 25 to 1 Fund and/or The Great American Barbecue Contest and/or agents authorized by them to use any photographs, videotapes, motion pictures, recordings and any other record of this even for any authorized purpose.
Total Due