Name *

First Name

Last Name

Phone

(###)

###

####

Waiver/Release *

If this is a group entry, each entrant will be required to sign a release form. If entrant is a minor, parent or guardian must sign the release. You must check that you agree to all statements below and you will be required to sign a paper release on site.

I/We have read and understand the rules of Haywood Comic Convention Cosplay Contest and agree to abide by them.

I/we agree to permit photography and/or videotapping and also agree to permit the use, sale and/or dissemination of said photographs and/or videotapes subject to permission from the Haywood Comic Convention staff.

I/We attest that my/our participation in this activity is purely voluntary and agree to hold the convention, its organizers, and the facility (Brownsville Arts Council, Visit Brownsville TN, City of Brownsville Tennessee, County of Haywood Tennessee, Boys & Girls Club, Haywood County Parks & Recreation, directors, officers, sponsors and volunteers) both severally and individually blameless for any accident and/or injury suffered by me/us during the course of this Cosplay Contest.

Date

MM

DD

YYYY