Vendor Information

	*Required Fields
First Name*
Last Name*
Company*
Address*
City*
State*	-- Pick a State -- Not Applicable Alabama Alaska Arizona Arkansas California Colorado Connecticut Deleware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Lousiana Maryland Maine Massachussets Michigan Minnesota Mississippi Missouri Montana Nebraska North Carolina North Dakota Nevada New Hampshire New Jersey New Mexico New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington District of Columbia West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Yukon
Zip*
Country*	-- Pick a Country -- United StatesCanadaOther
Phone*
Email*
Arrival Date*	-- Pick a Day -- Prior to Tuesday (9/3)Tuesday (9/3)Wednesday (9/4)Thursday (9/5)Friday (9/6)
Departure Date*	-- Pick a Day -- Prior to Friday (9/6)Friday (9/6)Saturday (9/7)Sunday (9/8)After Sunday (9/8)
Lodging*	-- Pick One -- Radisson Other (Specify)	If "Other", please specify:
Have you attended a previous CCR?*	-- Pick One -- Yes No		CCR I (Broken Bow) CCR II (Hot Springs)

Guest Information

	Use same Address as Rider
First Name
Last Name
Address
City
State	-- Pick a State -- Not Applicable Alabama Alaska Arizona Arkansas California Colorado Connecticut Deleware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Lousiana Maryland Maine Massachussets Michigan Minnesota Mississippi Missouri Montana Nebraska North Carolina North Dakota Nevada New Hampshire New Jersey New Mexico New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington District of Columbia West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Yukon
Zip
Country	-- Pick a Country -- United StatesCanadaOther
Phone
Email
Additional Names:

Legal 

You will be required to sign the Accident Waiver and Release of Liability AND the Assumption of Risk Acknowledgement upon On-Site Check-In at the Reunion Site.

ACCIDENT WAIVER AND RELEASE OF LIABILITY: YOU MUST AGREE IN ORDER FOR THIS ONLINE REGISTRATION TO BE PROCESSED

By taking part in a Curve Cowboy Reunion (CCR) event, either by competition or the registration process, the participant (or if a minor, the parent or legal guardian who consents to the minor entering) admits complete and comprehensive understanding and approval the terms in the CCR "Accident Waiver and Release of Liability" form and any state or local laws.

All entrants must affix their original signature to and surrender to CCR the written release form and CCR Accident Waiver and Release of Liability" form by the closing time of their registration period for the event.

The stipulations in the CCR "Accident Waiver and Release of Liability" form shall be absolutely binding even when an CCR "Accident Waiver and Release of Liability" form has not been signed and surrendered to the CCR.

DISCLAIMER

All who participate in any CCR event act at their own risk. CCR makes no express or implied warranty of safety or guarantee against damage, loss, harm, injury, or death to participants, and therefore, no liability shall be affixed to CCR or any of its members, sponsors, promoters, or officials for detriment or injury resulting from participating in CCR events.

By this instrument I hereby release CCR, any and all volunteers and all other persons and organizations involved in the CCR. I recognize and acknowledge that participating in this event is a potentially dangerous activity that may be stressful and may aggravate existing physical or mental conditions or cause new ones. I understand that such participation can be dangerous and that the dangers may include damage to or destruction of personal property, serious physical injury or even death. I represent that:

1. I am 18 year of age or older.

2. I am submitting this release, waiver of liability, and assumption of risk declaration voluntarily and of my own free will.

3. I have had no physical or emotional problems, nor any history thereof, which will impair his/her ability to participate in the event.

4. I understand and EXPRESSLY ASSUME all the dangers incident to participating in this CCR event and hereby RELEASE ALL CLAIMS, including but not limited to, personal injury, property damage or destruction, and death, whether caused by NEGLIGENCE, breach of contract or otherwise, and whether for bodily injury, property damage or loss or otherwise, which I may ever have against the CCR, any of its officers, directors, employees, agents, volunteers, assigns, or successors and any other person or entity who is a participant in or promoter of this event as well as any supplier of materials and equipment employed in connection with my participation in the event;

5. I agree to assume all financial responsibility for any medical, rescue or other expenses that I may incur or may be incurred on my behalf and agree to defend, hold harmless and indemnify CCR, any of its officers, directors, employees, agents, volunteers, successors and assigns for any loss or damage, including attorneys’ fees, that they may suffer should I or anyone else on his/her behalf pursue an action or claim that is waived or barred by this release or waiver or any other claim by or on behalf of me arising out of the activity to which this release relates;

6. This waiver, release and assumption of liability shall be binding upon me, my heirs, executors, and administrators.

*I have read and understood the statement above and agree to the conditions.