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14th Annual Fall Festival & Car Show October 20, 2012
OFFICIAL ENTRY FORM
$50 Per Concession Space.10'X10' Mail Entries to Moapa Valley Chamber of Commerce P.O. Box 361 Overton, NV 89040

Type of Concession________________________________________________________

Owner's Name________________________________________________________

Address_______________________________________________________________

City/State/Zip_________________________________________________________

E-mail Address_________________________________________________________

RELEASE OF LIABILITY--By execution of this form, I release all persons of the show, sponsors, Clark County Parks & Rec., their agents and employees, from any and all damages, injuries or losses suffered by any participant, to his person or property. I agree to abide by all rules and regulations of the show.