Street Address: Phone:

        City: State: Zip:

        Date of birth: Age:

        Parent/Guardian:

          The undersigned agrees that participation in this event can be dangerous and result in injury to child. Parent/Legal Guardian hereby releases the City of Eunice from any and all legal responsibility for any injury suffered while riding in the Eunice Little Mardi Gras Run, knowing full well that this release must be granted as part of the consideration for allowing child to ride in the parade.

            Further, below signed agrees to indemnify and hold harmless the City of Eunice, its officials and employees from any and all claims brought for personal injury or property damage to child or guardian and any blood relatives of said child or guardian, including undersigned, by any person, said indemnity agreement to include legal fees and defense costs incurred by any indemnity.

       
             Parent/legal guardian                                                     Date

We Run - RAIN OR SHINE
* NO REFUNDS *