Contestant Name *

First Name

Last Name

Parent Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Waiver *

I hereby give my child permission to enter the Kiddie Queen and King Contest. I have read the rules and expectations and understand that a violation of any of these will result in disqualification from the competition. I also understand that the festival, festival directors, and contest directors are not responsible for any injury or loss of personal property that might occur due to the participation in the Kiddie Queen and King Contest; and we, therefore, agree to indemnity, hold harmless and defend any action against the City of Shelby, Community Improvement Corporation of Shelby, and the Shelby Bicycle Days festival team from and against all liabilities whatsoever arising out of our participation in the Kiddie King and Queen Contest.

I Agree

I Disagree