Parade Registration Form Heritage Square, Peoria Heights, IL 61616 Parade: Saturday June 20, 2015, 10 AM. Check in: 9:00 AM Register in advance at www.peoriaheightschamber.com or return this form by mail no later than June 15 to the following address: Peoria Heights Chamber of Commerce PO Box 9783 Peoria, IL 61612 Group Name: ________________________________________________________________________ Contact Name: ______________________________________________________________________ Contact Address: ___________________________________________________________________ Contact Phone Number: ____________________________________________________________ Contact Email Address: ____________________________________________________________ Please describe your group and their parade presentation (to be used by the parade emcee): __________________________________________________________________________________________ __________________________________________________________________________________________ _________________________________________________________________________________ Special needs for your group or additional comments: __________________________________________________________________________________________ ____________________________________________________________________________________ For questions you may call the Peoria Heights Chamber of Commerce at 309-282-7733 Note: Registration does not ensure placement in the parade Duryea Festival Parade Release of Liability Please sign and return one Release of Liability form for every adult or child participating in the Duryea Festival parade. This form must be signed by a parent or guardian if the participant is under the age of 18. Return forms by mail to the Peoria Heights Chamber of Commerce, P O Box 9783 Peoria, IL 61612 before June 15, 2015. Release of Liability The undersigned is a participant in the Duryea Festival parade on Saturday, June 20, 2015. By participating in the parade, the undersigned hereby agrees to assume all responsibility and liability for any and all damage, personal injury, or other loss of any nature and further releases and agrees to hold harmless the Peoria Heights Chamber of Commerce and its agents from any and all liability, claims, damages, and causes of action of any nature related to said parade. The undersigned hereby acknowledges and certifies that he or she has read the Duryea Festival Parade Release of Liability, fully understands the contents, and by signing below agrees to all terms and conditions included therein. ________________________________________ Participant Name ________________ Age ________________________________________ Participant Signature ________________________________________ Parent or Guardian Signature (if under 18) ________________ Date Signed ___________________________________________________________ Address ___________________________ Phone Number ______________________________ Email address
© Copyright 2024