HALLOWEEN

HAUNTED TRAIL FESTIVAL

REGISTRATION and

LIABILITY WAIVER FORM

October 2010

I (adult) and the following children are participating in the Halloween Haunted Trail Festival:

Adult’s Name:___________________________________________________________

Child’s Name:___________________________________________ Age:____________

Child’s Name:___________________________________________ Age:____________

Child’s Name:___________________________________________ Age:____________

Child’s Name:___________________________________________ Age:____________

Child’s Name:___________________________________________ Age:____________

and I recognize that the activities associated with the Seymour Land Conservation Trust, Inc. Halloween Haunted Trail Festival may be HAZARDOUS AND VERY DANGEROUS. I hold the Seymour Land Conservation Trust, Inc. harmless from any damages or liabilities that may result from our participation in this program. I agree to actively monitor and supervise my child/children’s activities during this extensive program.

Signed:________________________________________________________________________

Street, City, Zip:________________________________________________________________

________________________________________________________________

Are you presently a member of the Seymour Land Trust? Yes ÿ No ÿ

Would you like to become a Seymour Land Trust member? Yes ÿ No ÿ