Please fill in the information below (* indicates required field)
Artist Name *
Contact First Name *
Contact Last Name *
Played EC Before? *
Year last played EC
Please mark availability (most set times will be 45-90 minutes long, spread among several stages)
In consideration for Kesey Enterprises Inc. allowing the above described business or organization to participate in the Eugene Celebration, I, the undersigned, being duly authorized by the application vendor, and on its behalf, and on behalf of its personal representatives, owners, employees, volunteers and agents, hereby waive, discharge, and release any and all rights and claims for injury to myself or others, and for loss or damage to personal property and the property of the organization, including theft or vandalism thereof, that may be suffered as a result of said participation in the Eugene Celebration. On behalf of myself, the above described business or organization and its employees, volunteers, and agents, I further authorize the taking and use of photographic images of the booth, personal representatives, employees, volunteers and agents, associated with said business or organization for future promotional use by the Eugene Celebration and waive any and all rights to said images or revenue derived from said images.
* I have read, understand and accept the terms of the release agreement and application.
(please type "YES" to agree)
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