REGISTRATION FORM ONLY – Texas Line Dance Jamboree "TX JAM"

Name - (As You Want It On Your Nametag) (REQUIRED FIELD) *

First

Last

Address (REQUIRED FIELD) *

Address Line 1

Address Line 2

City

State

Zip Code

Email Address (REQUIRED FIELD) *

Cell Phone (REQUIRED FIELD) *

Emergency Contact Name (REQUIRED FIELD) *

First

Last

Emergency Contact Phone Number (REQUIRED FIELD) *

Sunday Lunch (Includes Sandwich, Chips & Cookie) (REQUIRED FIELD)

Ham On White Bread

Ham On Wheat Bread

Turkey On White Bread

Turkey On Wheat Bread

Chicken Salad On A Croissant

Veggie Wrap

Gluten Free Box Lunch (Additional Charge)

Please select Ham, Turkey, Chicken Salad or Veggie (It will not have regular bread)

* REGISTRATION FEE * - $55 (REQUIRED FIELD) *

I, herereafter referred to as "Participant", (whose name is listed above) am freely and voluntarily seeking to participate and engage in the activities of the Texas Line Dance Jamboree, (hereinafter referred to as "Activity") located at the Waco Convention Center, Waco, TX, sponsored by Cheryl Rogers. Participant acknowledges that there may be inherent risks associated with line dance and social dance events, whether entering, attending, participating in, or leaving the Activity. With full knowledge and appreciation of these and other inherent risks of the Activity, Participant freely and voluntarily assumes the risks of the activities involved in any aspect of the Activity. In this connection, Participant also voluntarily agrees to waive any and all rights to sue and hereby releases Sponsor(s), committee members, the Waco Convention Center and the County of McLennan, their employees, agents, and representatives ("Released Parties") from all liability, loss, claims or causes of action for injury, death, expenses, or damage to person or property resulting from the inherent risks of the Activity, or resulting from any action or inaction by the Sponsor(s) or Released Parties. This waiver and release shall be effective even if the injury, death, or damage to person or property is caused by or contributed to by actions or failure to act of the Sponsor(s) or Release Parties which were negligent or in violation of any applicable law. Participant agrees that this Assumption of Risk, Waiver and Release of Liability shall be enforced to the greatest extent permitted by law. If any clause of this Assumption of Risk, Waiver and Release of Liability conflicts with applicable law, only that clause will be null and void, but the remainder shall stay in full force and effect. *

(REQUIRED FIELD) I the Participant (whose name is listed above), have read this Assumption of Risk, Waiver, and Release or Liability Agreement, I understand it and I agree to be fully bound by its terms.

I understand and acknowledge that NO REFUNDS will be issued under any circumstances. I expressly authorize any and all still pictures and videos of this event that include attendees. * *

(REQUIRED FIELD) I the Participant (whose name is listed above) have read, understand, and acknowledge the NO REFUND policy. I also authorize any and all still pictures and videos of this event that include attendees.

damage attendees. the

(REQUIRED FIELD) Electronic Signature of Participant *

Clear Signature

Total Amount

Item Quantity Qty Total

There are no products selected.

Ham On White Bread - Included With Your Registration Fee 0 $0.00

Ham On Wheat Bread - Included With Your Registration Fee 0 $0.00

Turkey On White Bread - Included With Your Registration Fee 0 $0.00

Turkey On Wheat Bread - Included With Your Registration Fee 0 $0.00

Chicken Salad On A Croissant - Included With Your Registration Fee 0 $0.00

Veggie Wrap - Included With Your Registration Fee 0 $0.00

Gluten Free Box Lunch (Additional Charge) - Extra Cost Associated With This Option 0 $0.00

* REGISTRATION FEE * - $55 (REQUIRED FIELD) - All Open Dance, Saturday Denim Diamonds & Pearls Pre-Jam Party, Sunday Jamboree/Lunch 0 $0.00

Subtotal

Total $0.00

HOW ARE YOU PAYING? PAYMENT MUST BE RECEIVED FOR ORDER TO BE COMPLETE (REQUIRED FIELD) *

Zelle (txjamboree@gmail.com) (THIS WILL NOT DRAFT MONEY. YOU WILL NEED TO GO THROUGH YOUR BANK TO PAY)
Venmo (@Cheryl-Rogers-127) (THIS WILL NOT DRAFT MONEY. YOU WILL NEED TO GO THROUGH THE VENMO APP TO PAY)
Check - Email txjamboree@gmail.com for the mailing address