IN CONSIDERATION OF YOUR ACCEPTANCE OF THIS ENTRY, I HEREBY WAIVE FOR MYSELF, MY HEIRS, AND ASSIGNS, ANY AND ALL CLAIMS FOR INJURY OR DAMAGES, WHICH I MAY INCUR BY VIRTUE OF MY PARTICIPATION IN THE LAGRO STREET FAIR AS A CONCESSIONS/VENDOR PROVIDER, AS AND AGAINST THE TOWN OF LAGRO, LAGRO TOWN BOARD MEMBERS, LAGRO STREET FAIR BOARD MEMBERS, AND THEIR AGENTS AND/OR EMPLOYEES. I FURTHER REALIZE AND ASSUME ANY AND ALL RESPONSIBILITY FOR MY OWN WELLBEING AND/OR THAT OF ANY EMPLOYEE OR PARTICIPANT WITH REGARD TO MY CONCESSION/VENDOR. LAGRO STREET FAIR IS NOT RESPONSIBLE FOR ANY BROKEN OR STOLEN ITEMS INSIDE OR OUTSIDE OF TENTS. I HAVE ENCLOSED A PROOF OF CERTIFICATE OF LIABILITY INSURANCE TO THE LAGRO STREET FAIR BOARD IF I HAVE ONE. IN ADDITION, I CERTIFY, BY MY SIGNATURE, THAT IHAVE READ THIS WAIVER AND FULLY UNDERSTAND AND ACCEPT IT TERMS. DO NOT SIGN THIS WAIVER BEFORE READING FULLY AND CAREFULLY. IF YOU DO NOT AGREE WITH THESE TERMS, DO NOT SIGN.
Agency Number 260-782-2541, PLC# 3274