Bernie’s Annual Bed Race Registration – Frankton Heritage Days Festival

Name: *

Street Address: *

City:*

State: *

Zip:*

Phone Number: *

Date of Birth: *

Competition Category: *

21 & Over

Open/Family (must have 2 adults on team)

Participating Team Name:*

Participating Team Captain's Name: *

Team Phone Number: *

*Please Note: Registration Fee is $10 Per Participant (T-Shirt Cost)*
After submission of this registration form you will be able to make your t-shirt purchases. Sizes available include: Youth Small, Youth Medium, Youth Large, Small, Medium, Large, X-Large & XX-Large.

LIABILITY WAIVER

I am willfully participating in the Bernie’s Annual Bed Race. I understand there may be risk of injury to myself or someone in my team. I have been encouraged to wear the appropriate safety equipment by the festival and understand that if I choose not to wear the appropriate equipment, that it is my choice and accept responsibility. I agree to withhold any liability from the Frankton Heritage Days Festival, Bernie’s Bar, and/or the Town of Frankton. I have read the rules and regulations of the race and agree to the terms.

A copy of this Liability Waiver must be signed the day of the race and witnessed by Frankton Heritage Days Festival Personnel.

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