Lago Vista 4th of July Family Activities Entry Form

Please enter the information for your Family Activities entry into the form below and click on the Submit Entry Form button to submit your entry.

* indicates a required field. You must fill in all required fields in order for your entry form to be accepted.

First Name:*	Last Name:*

Street Address:*	City:*

State:*	Zip Code:*

Phone Number:*	Emergency Phone Number:*

E-Mail: (Please see note (1) below)

Birthdate:*

Gender:*

Family Activities:* (Please see note (2) below)
Cow Chip Contest Bean Bag Toss Moon Walk Egg Toss Lawn Bowling Water Gun Contest Oreo Eating Contest Tug of War Lemon & Pencil Race Three Legged Race Saltine Cracker Whistling Contest Water Balloon Passing Pie Eating
Comments:

(1) Please enter an e-mail address if possible. If you specify an e-mail address, a copy of your entry form will be sent to the e-mail address you provide.
(2) Please check the appropriate box for each family activity you wish to participate in. All necessary items will be provided.
Release from Liability and Indemnification We wish to participate in Lago Vista 4th of July Family Activities. We, individual(s) or organization, Indemnify and Hold Harmless the Lago Vista 4th of July Council, its Volunteers, the City of Lago Vista from any and all claims, suits, losses, damages, expenses on account of Lago Vista 4th of July Family Activities. Further, the noted individual(s) or organization will defend the Lago Vista 4th of July and the City of Lago Vista, and its agents from all claims or bodily injury or property damage arising from their participation in Lago Vista 4th of July Family Activities. We understand that we are responsible for our own safely and actions. By checking the box below, I, the individual named in the First Name and Last Name boxes above, signify that I have read this Agreement and understand and agree to all its terms.
I have read the above Release from Liability and Indemnification agreement and understand and agree to all its terms.
I agree