In consideration of participating in the "Eat Campbellsport Contest" on July 3^rd 2005 in Campbellsport, I attest to the fact that I understand the nature of the event and that I am qualified, in good health, 18 years old or older and in proper physical condition to participate in such event. I promise that, in the event conditions appear unsafe, I will immediately discontinue participation in the event.

I fully understand the event involves risk of bodily injury, which may be caused by my own actions or inactions, those of others participating in the event, the condition in which the event takes place, or the negligence of the "releases" named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and responsibility for losses, costs and damages I incur as a result of my participation in this event.

I hereby release, discharge and covenant not to sue the Campbellsport Firemen or Fire Department, Campbellsport Area Chamber or Commerce, all perspective business or personal entities involved in the contest, the Village of Campbellsport, their respective administrators, directors, agents, officers, volunteers, employees, other participants, sponsors or advertisers and, if applicable, owners and lessors of premises on which the "Eat Campbellsport Contest" takes place (each considered one of the "RELEASEES" herein) from all liability, claims, demands, losses or damages on my account caused or alleged to be caused in whole or in part by the negligence of the "Releasees" or otherwise, including negligent rescue operations. I further agree that if despite this release, waiver or liability and assumption of risk I, or anyone on my behalf, makes a claim against any of the Releasees: I will indemnify, save, and hold harmless each of the Releasees from any loss, liability, damage or cost which may incur as a result of such claim. I have read this release and waiver of liability and assumption of risk and fully understand it. I further attest by my signature that I agree with the conditions above.

By my signature below, I also give the Campbellsport Area Chamber of Commerce, the Campbellsport Fire Department or the Campbellsport News my consent to photograph and/or video me, with or without name, for educational, informational, or promotional purposes. Due to editing, I understand that I may or may not be featured in any publicity.

Date of event: July 3, 2005

By signing below I agree to the above terms and conditions (must be signed prior to competition):

___________________________________ / __________________________________   

Participant Name: _____________________________________________

 Address: ____________________________________________________

_____________________________________________________________

 Phone Number: ______________________________

 E-Mail: ______________________________________

T-Shirt Size:_____________________

 ________________________________________ agrees to donate $20.00 to participate in the 2005 Eat Campbellsport Contest. Entry fee includes a commemorative T-Shirt.