WALLACETOWN FAIR ENTRY FORM

I make the following entries in good faith, carrying all responsibility myself and will not hold the Wallacetown Agricultural Society liable for theft or damage of any kind and agree to be governed by the rules and regulations of the society as contained in the Prize List.

Exhibitor Name: ________________________________________ Exhibitor Number: ______________

Address: ___________________________________________________________________________

City: ___________________________________________________ Postal Code:________________

Phone Number: ____________________            your e-mail: _________________________________

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Print out this form, complete, and then mail to:
Shelly Wilkinson, Secretary, RR#1 Wallacetown, Ontario N0L 2M0
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Hold Harmles Agreement:  I, as exhibitor-named above, shall indemnify and Hold Harmless, the Wallacetown Agricultural Society, their members, agents and employees for and against all claims, losses, costs, damages, suit or proceedings by any third parties that may arise out of, or may attribute to all operations performed by or carried out by the Wallacetown Agricultural Society, its agents, employees or servants, or anyone for whose acts it may be held liable, howsoever caused.

Signature: __________________________________________________ Date: __________________

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