* 1. Contact Information:

* 2. Please check each box to verify that you understand deadlines:

* 3. Please check each box to verify that you understand the parade:

* 4. Entry Name & Description

* 5. I authorize that I have for each individual participating with my entry that release, remise, waive and forever discharge the following from all liability, claims, demands, actions, or causes of action whatsoever arising out of or related to loss, damages and/or injuries, including death, which may result from participation in the above named event involving roads within the state of Utah. (each box must be checked.)

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