Online Melon Run Registration Form Name * Driver or Passenger? * -Select-DriverPassenger Mailing Address * City * State * ZIP Code * Home Phone Other Phone Email Address Make of Motorcycle * Model * Year * In consideration of Farmerville Jaycees, Louisiana Watermelon Festival and the Louisiana Melon Run accepting this application, the undersigned for myself, my heirs, executors, administrators, and assigns hereby release and agree to indemnify and hold harmless Farmerville Jaycees, Louisiana Watermelon Festival and the Louisiana Melon Run, their sponsors, organizers, committee officials and each of their respective representatives, agents or employees from any claim, demands, damages, actions or causes of action arising out of or in consequence of any loss, injury, or damage to my person or property incurred from any cause whatsoever, in consequence of attendance or participation in the Louisiana Melon Run event notwithstanding that any such loss of injury or damage may have arisen by reason of the negligence of Farmerville Jaycees, Louisiana Watermelon Festival or the Louisiana Melon Run, its sponsors, organizers and committee officials harmless and does hereby indemnify them from any and all liability for personal injury or property damage to third parties which may occur in any manner arising out of my attendance or participation in said Louisiana Melon Run. The undersigned further acknowledges that the Louisiana Melon Run is not a race and that speed in no way determines the outcome of the event and hereby agrees to abide to all the rules, directives, and conditions of the Melon Run, as set forth by the organizers, either verbally or in writing, before or during the Melon Run. The undersigned further agrees that the motorcycle named in the application form is in safe operating condition and complies with and meets any and all highway specifications put forward by the Louisiana Department of Transportation. I further certify that the above motorcycle is insured for a minimum of Public Liability and/or Property Damage. Please read the following legal waiver. You must agree to this waiver in order to participate. By selecting the "Yes" option below, you are digitally signing your name on the registration form, and agreeing to abide by the below waiver: In consideration of Farmerville Jaycees, Louisiana Watermelon Festival and the Louisiana Melon Run accepting this application, the undersigned for myself, my heirs, executors, administrators, and assigns hereby release and agree to indemnify and hold harmless Farmerville Jaycees, Louisiana Watermelon Festival and the Louisiana Melon Run, their sponsors, organizers, committee officials and each of their respective representatives, agents or employees from any claim, demands, damages, actions or causes of action arising out of or in consequence of any loss, injury, or damage to my person or property incurred from any cause whatsoever, in consequence of attendance or participation in the Louisiana Melon Run event notwithstanding that any such loss of injury or damage may have arisen by reason of the negligence of Farmerville Jaycees, Louisiana Watermelon Festival or the Louisiana Melon Run, its sponsors, organizers and committee officials harmless and does hereby indemnify them from any and all liability for personal injury or property damage to third parties which may occur in any manner arising out of my attendance or participation in said Louisiana Melon Run. The undersigned further acknowledges that the Louisiana Melon Run is not a race and that speed in no way determines the outcome of the event and hereby agrees to abide to all the rules, directives, and conditions of the Melon Run, as set forth by the organizers, either verbally or in writing, before or during the Melon Run. The undersigned further agrees that the motorcycle named in the application form is in safe operating condition and complies with and meets any and all highway specifications put forward by the Louisiana Department of Transportation. I further certify that the above motorcycle is insured for a minimum of Public Liability and/or Property Damage. I have read the above legal waiver and I agree to its terms * Yes No By selecting "Yes" you are temporarily digitally signing your name. You will be asked for your signature in person during check-in at the registration tent. Today's Date * [MM/dd/yy] Please choose a payment option I will pay online I will pay by mail Registration is $15.00 per person. Please complete a Registration Form for each person. You may pay online by selecting the payment button on the Registration Page of our website, or you may pay by mail. If you choose to mail your payment, please make checks payable to Louisiana Watermelon Festival, and mail them to P.O. Box 49, Farmerville, LA 71241. Please remember that both your Registration Form and all fees MUST be received in order for you to be considered registered. (if you are pre-registering, these must be received by July 7, 2008) You will receive a confirmation email once your payment has been received. You will receive a verification email (or phone call) once your Registration Form and payment have been received. Please make sure that the email and phone number(s) you provided are correct. Registration is $15.00 per person. One Registration Form per person must be completed. You may pay online through Paypal by following the link below this application or you may pay by mail. Please make checks payable to Louisiana Watermelon Festival, and mail them to P.O. Box 49, Farmerville, LA 71241. Please remember that your completed registration form AND your registration fee(s) must be received in order to complete your registration. (If you are pre-registering, these must be received by July 7, 2008) View Error Details Powered by
In consideration of Farmerville Jaycees, Louisiana Watermelon Festival and the Louisiana Melon Run accepting this application, the undersigned for myself, my heirs, executors, administrators, and assigns hereby release and agree to indemnify and hold harmless Farmerville Jaycees, Louisiana Watermelon Festival and the Louisiana Melon Run, their sponsors, organizers, committee officials and each of their respective representatives, agents or employees from any claim, demands, damages, actions or causes of action arising out of or in consequence of any loss, injury, or damage to my person or property incurred from any cause whatsoever, in consequence of attendance or participation in the Louisiana Melon Run event notwithstanding that any such loss of injury or damage may have arisen by reason of the negligence of Farmerville Jaycees, Louisiana Watermelon Festival or the Louisiana Melon Run, its sponsors, organizers and committee officials harmless and does hereby indemnify them from any and all liability for personal injury or property damage to third parties which may occur in any manner arising out of my attendance or participation in said Louisiana Melon Run. The undersigned further acknowledges that the Louisiana Melon Run is not a race and that speed in no way determines the outcome of the event and hereby agrees to abide to all the rules, directives, and conditions of the Melon Run, as set forth by the organizers, either verbally or in writing, before or during the Melon Run. The undersigned further agrees that the motorcycle named in the application form is in safe operating condition and complies with and meets any and all highway specifications put forward by the Louisiana Department of Transportation. I further certify that the above motorcycle is insured for a minimum of Public Liability and/or Property Damage.
You will receive a verification email (or phone call) once your Registration Form and payment have been received. Please make sure that the email and phone number(s) you provided are correct.
