Home  CosFest CosFest Participant Waiver Form
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CosFest Participant Waiver Form |
All participants must sign this required form to lock their entry into CosFest. Minors must fill out and sign the Minor Permission Form.
PMX CosFest Participant Waiver Form
CosFest Participant Waiver Form
- Please print this important form from your computer and submit it to the CosFest Office when you check in.
- All minors (17 and below) must fill out a Minor Permission form.
- For group entries, each member of your group must turn in a copy of this form.
Participant's Name: ___________________________________________________________
Group Name: ___________________________________________________________________
Date of birth: __________________________________ Age: _________________________
Phone Number: _________________________________________________________________
Address:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
I, ___________________________________________ (please print), will participate in the
Pacific Media Expo 2007 CosFest events taking place November 7 - 9th, 2008. I further
give my consent to Pacific Media Expo to acquire emergency medical treatment from
competent medical personnel/facilities should that become necessary for any reason.
I also grant Pacific Media Association the right to use my name, likeness and/or footage
taken for promotional purposes. My signature below indicates that I understand that I 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. My signature below constitutes and is evidence of my agreement to
(1) accept general liability for the participation of myself 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 my participation in CosFest.
Signature ____________________________________________________________
Date ______________________________________________
© 2008 Pacific Media Expo
Images used with permission and are copyrighted by their respective owners.
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