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

Name (As You Want It On Your Nametag) *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Cell Phone Number *

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

FRIDAY LUNCH INCLUDED ~ (Includes Chips, Cookie, And Pickle) *

SATURDAY LUNCH INCLUDED ~ (Includes Chips And Cookie) *

Roast Beef & Pepper Jack Cheese on a Fresh French Roll
Turkey & Swiss on a Buttery Croissant
Chicken Salad Sandwich on a Buttery Croissant
Veggie Spinach Wrap in a Fresh Spinach Wrap

REGISTRATION FEE ~ Includes Friday Workshop/Lunch ~ All Open Dance ~ Friday Pre-Jam Party ~ Saturday Jamboree/Lunch *

Zelle - $90.00 Registration Fee
Venmo - $90.00 Registration Fee
A Check Is In The Mail - $90.00 Registration Fee

the Address all

I, herereafter referred to as "Participant", (who's 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. *

I the Participant (who's 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. This serves as my electronic signature.

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. *

I the Participant (who's 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. This serves as my electronic signature.

Electronic Signature *

Clear Signature