EAST COBBER Festival Entertainment Application Sponsoring Organization*Contact Name* First Last TitleEmail* Phone*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Theme / Title of Entry*Number of Performers*Length of Act*Description of Performance* 2019 EAST COBBER Festival Entertainment Liability DisclaimerIn consideration of participation in said Festival, the individual/group/organization/business does hereby release, defend, indemnify and save harmless the EAST COBBER, its officers, directors, employees, and any other person, firm or corporation charged or chargeable with responsibility or liability, jointly and severally from any and all actions, claims and demands for, upon or by reason of any damage, loss or injury, which hereafter may be sustained by participating in the EAST COBBER Festival.This release extends and applies to, and also covers and includes, all unknown, unforeseen unanticipated and unsuspected injuries, damages, loss and liability, and the consequences thereof, as well as those now disclosed and known to exist. The provisions of any state, federal, local or territorial law or statue providing in substance that releases shall not extend to claims, demands, injuries or damages which are unknown or unsuspected to exist at the time, to the person executing such a release, are hereby expressly waived.I hereby agree on behalf of my heirs, executor, administrators, and assigns, to indemnify all members and officials of the EAST COBBER, jointly and severally and hold harmless from and against any and all actions, claims, demands and liabilities, loss damages and expense of whatever kind of nature, including attorney fees, which may at any time be incurred by reason of the participation in EAST COBBER Festival.It is further agreed and understood that said participation in the EAST COBBER Festival, is not to be construed as an admission of any liability and acceptance of assumption of responsibility by the EAST COBBER, its officers and members, jointly and severally, the participant shall indemnify the EAST COBBER for which the EAST COBBER, its officers and members, jointly and severally, become liable as a result of any alleged act of the Festival participant.Name of Organization / business /group/ individual*Name First Last Title*PhoneEmail Address Street Address City State / Province / Region ZIP / Postal Code * I have read, understand and agree to the terms of the liability disclaimer policy. After completing the EAST COBBER Festival Entertainment application and the above disclaimer, please submit this form no later than August 2, 2019. Questions? Call 770-640-7070. All applicants will be notified of their performance time by September 4, 2019. This iframe contains the logic required to handle Ajax powered Gravity Forms.