WORLD RECORD PIE FIGHT AGREEMENT, RELEASE AND ASSUMPTION OF RISK
I wish to participate in the Center Ring Circus School, LLC World Record Shaving Cream Pie Fight to help raise awareness and
funds to support the non-profit mission of Bridges to Housing Stability, Inc. I understand that while participating in this
physical event, hazards exist and I am aware of and appreciate the risks that may result. I am also aware that accidents may
occur during this event, which could result in serious injury or death. I am voluntarily participating in this event with
knowledge of the dangers involved and I agree to accept all risks of injury or death.
I agree that any funds I raise through my participation in this event will be donated to Bridges to Housing Stability, Inc. Any
checks received will be made payable to Bridges to Housing Stability Inc., with reference to my name and the Center Ring
Circus School Pie Fight event. I will provide all funds collected, whether checks or credit card, on or before the fundraising
deadline 4-22-15.
In consideration for being permitted to participate in this even, I agree to assume all risks and to release, hold harmless and
covenant not to sue the Center Ring Circus School, LLC; Bridges to Housing Stability, Inc; event team members or captain(s);
and any designated beneficiaries, sponsors, officials, participating clubs, communities, organizations, friends of the event, and
all affiliated organizations and all their respective directors, officers, agents, employees and members (collectively, the
releases), from any claim, loss or liability that I may have arising out of my participation in the event, including bodily injury,
death or property damage, whether caused by negligence or carelessness of the releases or otherwise.
I intend by the Waiver and Release in advance to waive my rights and to discharge all the releases from all claims, losses, or
liabilities for death, bodily injury or property damage that I may have, or which may hereafter accrue to me, as a result of my
participation in this event, even though that liability may arise from negligence or carelessness on the part of the releases, from
dangerous or defective property or equipment owned, maintained or controlled by them or because of the possible liability
without fault. I understand and agree that the Waiver and Release is binding on my heirs, assigns and legal representatives.
I am physically capable of completing this event. If I am aware of or under treatment for any physical infirmity, ailment or
illness, my medical care provider knows of and has approved my participation in this event. I will maintain personal health
insurance while participating in the event. I acknowledge that I, and I alone, am entirely responsible for my personal health and
safety, and the personal property I bring with me.
I understand that all donations processed by Bridges to Housing Stability, Inc. are non-refundable and non-transferable even if I
don't participate in the event. I understand that my photograph or likeness recorded at the event may be used by the Center Ring
Circus School, LLC and Bridges to Housing Stability, Inc. and their sponsors, beneficiaries, licensees, affiliates and employees.
I consent to and authorize, in advance, such use and waive all rights of privacy. I have in connection therewith. And I
understand that I will not benefit financially from any use thereof.
I hereby grant CRCS full permission to take any photographs, videos or other recordings at this event that may include me,
either alone or with others, and to use them for any purpose without reimbursement of any kind.
I have carefully read this Waiver and Release and fully understand its contents. I am aware that by accepting this Waiver and
Release, I am waiving legal rights and knowing this, I accept it of my own free will.
Signature of Participant __________________________________ Print Name_______________________________________
Address________________________________________________________________________________________________
Phone__________________________________ Email: ________________________________________________________
Date ___________________________________
Center Ring Circus School
6770 Oak Hall Lane Suite 105
Columbia, MD 21045
443-996-8197
www.CenterRingCircusSchool.com
WORLD RECORD PIE FIGHT AGREEMENT, RELEASE AND ASSUMPTION OF RISK
Page 2
PARENT'S OR GUARDIAN'S ADDITIONAL INDEMNIFICATION
(Must be completed for participants under the age of 18)
In consideration of the following named individuals (“Minor”) being permitted to participate in this event, I further agree to
indemnify and hold harmless Center Ring Circus School, LLC and Bridges to Housing Stability, Inc. from any and all claims
which are brought by, or on behalf of Minor, and which are in any way connected with such participation by Minor.
(Please print)
1. Minor’s Name: ________________________________
8. Minor’s Name: ________________________________
Relationship to Minor: __________________________
Relationship to Minor: __________________________
2. Minor’s Name: ________________________________
9. Minor’s Name: ________________________________
Relationship to Minor: __________________________
Relationship to Minor: __________________________
3. Minor’s Name: ________________________________
10. Minor’s Name: ________________________________
Relationship to Minor: __________________________
Relationship to Minor: __________________________
4. Minor’s Name: ________________________________
11. Minor’s Name: ________________________________
Relationship to Minor: __________________________
Relationship to Minor: __________________________
5. Minor’s Name: ________________________________
12. Minor’s Name: ________________________________
Relationship to Minor: __________________________
Relationship to Minor: __________________________
6. Minor’s Name: ________________________________
13. Minor’s Name: ________________________________
Relationship to Minor: __________________________
Relationship to Minor: __________________________
7. Minor’s Name: ________________________________
14. Minor’s Name: ________________________________
Relationship to Minor: __________________________
Relationship to Minor: __________________________
Parent or Guardian Signature: _____________________________________________________________
Print Name: ___________________________________________ Date: __________________________
Telephone Number: _____________________________________
Center Ring Circus School
6770 Oak Hall Lane Suite 105
Columbia, MD 21045
443-996-8197
www.CenterRingCircusSchool.com