CosFest Minor
Permission Form
(please print
from your computer and submit it to the CosFest Desk when you check in.)
Minor's Name :____________________________________________________________
Date of birth: ________________________________________________________________
Guardian's Name: _____________________________________
Guardian's Relation to Applicant:
______________________________________________________
Pacific Media Expo (PMX) cannot
assume responsibility for the safety and welfare of minors while engaged
in the Cosplay Festival (CosFest) beyond
making reasonable provision for welcoming you as a chaperone for the minor
indicated.
Your signature below indicates that
you understand that your child must abide by
all rules, regulations and staff instructions while participating in the
contest, and that PMX staff cannot prevent injuries because they
cannot always control the conditions present or be present
at all times. Your signature below constitutes and is evidence of your agreement
to (1) accept general liability for the participation of your child in CosFest
and (2) indemnify and hold harmless Pacific Media Expo, Pacific Media Association
(PMA), its employees and agents, either jointly or severally, from and against
any
and all claims, damages,
causes of action or injuries, including reasonable attorneys’ fees and
costs expended in defense thereof, incurred or resulting from your child’s
participation in CosFest.
Applicant's or Guardian's
Signature:______________________________ Date:_______
Emergency Contact Address:
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
Emergency Contact Phone
#:
________________________________________________________
© 2008 Pacific Media Expo
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