Event:  Plenty of Fish Barn Party and Bonfire                                         

Starting Date and Time:  Saturday June 21, 2008 at 8:00AM               

Ending Date and Time:  Sunday June 22, 2008 at 12:00PM                

I agree to assume and release the land owner, Carol A. Overbey, and all others associated with the production of this event for any personal injuries, property damage or for the loss of life or property resulting from or in any way connected to this event.  I agree to freely sign this release form and to pay a fee of $4.00  for consumables that are required for the conducting of the event.  Upon submitting this form and fee I agree to accept and wear a wristband throughout the duration of the event. All guests are required to vacate the property by the close of the event mentioned above.

I shall be held responsible for my actions during this time. I agree that at any time if my behavior is determined to be unacceptable by those conducting the event that I will be asked to leave the property.  Failure to do so will result in police intervention and possible charge of trespassing.

Name:                                                                                                       

Address:                                                                                                    

Telephone:                                                                                               

Emergency Contact: