Arizona State Salsa Festival Registration Packet and Information

Arizona State Salsa Festival
Registration Packet and Information
ARIZONA STATE SALSA FESTIVAL 2011
REGISTRATION FORM
Individual/Team Name:
______________________________________________________________________
Category: Best Hot Salsa Best Mild Salsa Most Unusual
(Please note: If you wish to enter all three categories, you must fill out a separate registration form for each category)
Are you a restaurant (please circle)? YES NO
Head Chef:
Head Chef E-Mail:
Head Chef Address:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
City: __________________________ Arizona Zip: _____________
Head Chef Phone: Home: __________________________ Cell: __________________________
To the extent allowed by law, I hereby absolve AZPRA, its employees, sponsors, agents, independent contractors, and officers from all liability
which may arise as the result of my/our participation in activities I or any member of my family attends or registers into; and, in the event that
the above named participant is a minor, I hereby give my permission for his or her participation as indicated and in so doing absolve AZPRA, its
employees, agents, independent contractors, and officers from such liability. I am aware that if I have registered for a class involving physical
activity, I have taken care to enroll at a class level appropriate to my/our physical abilities and/or medical condition. I am aware that if I am
participating in a special event that I am liable for all issues arising to and pertaining to my participation and hereby resolve AZPRA of special
event liability. I release use of my/our photos taken during program participation from all and any claims and demands resulting from their use
in program publicity.
_______________________________________________________
Signature of Head Chef
Date Received
For Office Use Only
Initials
________________________
Date
Contestant Number
Approved
Please return this form to:
Arizona State Salsa Festival (Attn: Marty McDonald)
12950 North 7 th Street Phoenix, Arizona, 85022
Media Contact: Marty McDonald, Chairman – Cell: 480-236-6394 ** Email: arizonasalsafest@gmail.com