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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your phone number?

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* 4. At what email address would you like to be contacted?

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* 5. Liability waiver: I am aware of the risks of participation, which include, but are not limited to, acquiring hand crafted goods not necessarily prepared in licensed kitchens or factories. I understand that participation in this event is strictly voluntary, and I freely chose to participate.

I, and my heirs, in consideration of my participation in the Clinton Community Library (“CCL”) Food Swap, hereby release and hold harmless CCL Food Swap and its founders, members, Board and venue and any other people officially connected with this event, from any and all liability for damage to or loss of personal property, sickness or injury from whatever source, legal entanglements, imprisonment, death, or loss of money, which might occur while participating in this event.

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* 6. Photo waiver: I hereby authorize CCL to publish the photographs taken of me, and my name, for use in the CCL’s printed publications and website. I acknowledge that since my participation in publications and websites produced by CCL is voluntary, I will receive no financial compensation. I further agree that my participation in any publication and website produced by CCL confers upon me no rights of ownership whatsoever. I release CCL, its contractors and its employees from liability for any claims by me or any third party in connection with my participation.

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* 7. By submitting this survey, I am asking to participate in the food swap and I acknowledge and represent that I have read the foregoing Waiver of Liability and Photo Release.

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