West Virginia State Championship
Buckhannon, West Virginia
June 20, 2015
Rotary BBQ Application
In Partnership & Sponsored By The
BUCKHANNON ROTARY CLUB
The Rotary Foundation’s Polio Plus Program is the primary beneficiary
TEAM DETAILS Please Print or Type
TEAM NAME:________________________________________Rotary Club of:__________________________
Pitmaster:________________________________________________________________________________
Address:_________________________________________________________________________________
City:_______________________________________________ State:________ Zip:___________________
Cell Phone:___________________________________ Alt Cell Phone: ______________________________
Work Phone:__________________________________ Home Phone: ________________________________
E-Mail:______________________________________
***REMINDER: $100.00 of your entry fee will be contributed to the Rotary Foundation / Polio Plus in your club’s name
ENTRY FEE
(20x20 space)
EARLY BIRD DISCOUNT
$
150.00
$(_________)
**If you need electrical service at your site, please
contact us “in advance” to discuss your requirements
so we can assist with those arrangements.
~Deduct $25.00 if entry is Postmarked by 5/1/15
TOTAL DUE
150.00
$__________
Set-Up begins at 6:30 AM
-Saturday, June 20th–
on level, paved sites
Register Online -- Pay via PAY PAL OR mail form & check to:
ALMOST HEAVEN BBQ BASH, INC.
PO Box 2054
Buckhannon, WV 26201
PHONE: Jody: 304-439-3033 Mary: 304-439-0002
Cancel by 6/1/15: Refund less $25
Cancel after 6/1/15: No REFUND
Visit our website for more information at:
www.almostheavenbbqbash.com
TEAM NAME:__________________________________________Rotary Club of:_______________________
Pitmaster:________________________________________________________________________________
Cell Phone:___________________________________ E-Mail:______________________________________
Rig Size: if you’re bringing a large smoker/RV, etc.
Length: ________ Width: ________(no height restrictions)
Additional parking needed for: Car_____ Truck_____ Van_____ Other____________________________
~We will do our best to accommodate reasonable requests but your rig/equipment must fit in the space selected
on your entry form unless other arrangements have been approved “prior to arrival”
Lodging/Accommodations:
We have secured a limited number of discounted room rates at area hotels and campground/RV spaces.
There is no commitment on your part, but providing the following information will assist in our planning
to provide adequate accommodations for everyone.
We are self-contained and need no other accommodations.
We would be interested in hotel room(s) for the nights of:(please indicate # of rooms needed per night)
Friday, 6/19: _____
Saturday, 6/20: _____
We would be interested in an RV space (size: ___________________)
Friday, 6/19: _____
Saturday, 6/20: _____
We look forward to welcoming you to our “Almost Heaven BBQ Bash” in June!
If Applicable, initial here:______I will be bringing a pet and agree to have my pet(s) contained or leashed at all times.
WAIVER OF LIABILITY: In consideration of your accepting this entry, I, the undersigned, intending to be legally bound,
hereby for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages
I, my team or my guests may have against the Almost Heaven BBQ Bash, Inc. aka Almost Heaven BBQ Bash, City of
Buckhannon, WV, Buckhannon Rotary Club, Rotary International, The Rotary Foundation, event sponsors and the KCBS,
their representatives, successors, and assigns, for any and all injuries suffered by me, my team or my guests. Further,
I hereby grant full permission to Almost Heaven BBQ Bash, Inc. aka Almost Heaven BBQ Bash, City of Buckhannon,
WV, Buckhannon Rotary Club, Rotary International, The Rotary Foundation and the KCBS, their representatives and/
or agents authorized by them, to use any photographs, video tapes, motion pictures, recordings and any other record
of this event for any legitimate purpose. I agree to the terms of the Waiver of Liability, and I will abide by the rules
of the 2015 Competitor Packet, and the rules of the KCBS. This event is based on a first come basis. However, Almost
Heaven BBQ Bash, Inc. reserves the final right of refusal to any and all teams. There is no “Rainy Day schedule for this
event, and if required the event may be canceled in whole or in part by Almost Heaven BBQ Bash, Inc without prior
notice, with no cash refunds, however we will give free entry to the following year’s event.. I have read the rules and
regulations of the KCBS and Almost Heaven BBQ Bash, Inc.
CLUB PRESIDENTS’S SIGNATURE: ___________________________________________ DATE: _____________________