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Festa Italiana
Ruffino Grape Stomp
Application & Waiver Release
I, the undersigned,
attest and verify that I am physically fit and have
full knowledge of the risks involved. I have read the
entry information and rules and certify by my signature
my compliance. I hereby release Festa Italiana, Seattle
Center, the City of Seattle and any and all individuals
or companies associated with the event from responsibility
for any injuries or damages I may suffer as a result
of my participation in the Ruffino Grape Stomp.
Team Name:
____________________ Phone: ________________
Business
Affiliation or Sponsor: _________________________
TEAM
MEMBERS
Player #1
Name: ____________________
Phone: ________________
Address: _______________________________________________
Emerg. Contact: ____________________ Emerg. Phone:
________________
Tee Shirt Size: __________
Signature:
______________________________________________
##########
Player #2
Name: ____________________
Phone: ________________
Address: _______________________________________________
Emerg. Contact: ____________________ Emerg. Phone:
________________
Tee Shirt Size: __________
Signature:
______________________________________________
##########
Player #3
Name: ____________________
Phone: ________________
Address: _______________________________________________
Emerg. Contact: ____________________ Emerg. Phone:
________________
Tee Shirt Size: __________
Signature:
______________________________________________
*
Return
this completed application (including signature from
each team member for release) and a $24 entry fee to:
Tony
La Stella
Festa Grape Stomp
14323 - 64th Ave W.
Edmonds, WA 98026
FAX: (425) 743-5010
Teams will be scheduled on a first-come, first-served
basis upon receipt of completed application and entry
fee.
Good
Luck and May The Best Feet Win!
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