Name______________________________________________________     Birthday_____________________ Address___________________________________________________________ City________________________________   State______________________    Zip___________   T-shirt size_______ E-mail_____________________________________    Phone___________________   Cell_____________________ YOU MUST SIGN BELOW
			Waiver & Release
		In consideration of my participation in any of the activities on site or related to Beasley's Orchard, Haunted corn Maze, and other good and valuable consideration, I, the undersigned, hereby release, indemnity and hold harmless the releases identified herinafter from any and all claims, actions, costs, expenses, judgments or damages of any and every kind and character, whether statutory or arising in contract or loss of my property, directly or indirectly arising out of or in connection with or attributable to my participation in such activities, including but not limited to claims or damages for death, bodily injury, psychological trauma or property damage arising in whole or in part from the negligence of any of the releases and/or from negligence on my part. As used herein, the term "releases" shall mean (a)Beasley's Orchard; (b)any and all corporations, individuals or entities sponsoring or supporting the aforementioned activities; (c)any and all corporations, individuals or entities participating in the construction of and/or the operation of and/or any activities relating to the said activities; and (d)any and all corporations, individuals or entities who are in any way associated with any of these activities. I release any likeness of my image created while participating in any of the aforementioned activities to remain the sole property of Scare Crew Productions. I will adhere to Equal Opportunity and Harassment policies. The representatives of this maze may authorize any and all medical treatment and/or transport in the event I become ill or injured while participating in any of the activities on site or related to Beasley's Orchard. I hereby certify that I have read and understand the foregoing language and its effects. Signature___________________________________________________  Date___________________________ If under 18 years of age, this form Must be signed by a parent or guardian. Parental Signature______________________________________   Witness_____________________________________ Return Waiver to:      Megen Morgan, Scare Crew Productions                                1408 Blackwater Drive, Danville, IN   46122