2017 THE Louisiana Boil-Off • Warehouse 535, Lafayette, La
COOK-OFF TEAM REGISTRATION FORM
Team Name: ______
Professional _____Amateur_____ Corporate_____
Team Captain Name______
Phone Number______Alt. Phone ______E Mail______
Alternate Contact Name______
Phone Number______Alt. Phone ______E-Mail
ENTRY FEE: Check One Please
Professional: $300____ Amateur: $150____ Corporate: $500____
REGISTRATION FORMS DUE BACK ASAP TO RESERVE YOUR SPOT
Registration fees are due by April 10, 2017.
EACH SPOT IS 10L X 10W and teams must provide their own tent (company-branded tents acceptable)
*Team Registration capacity is 50 teams.
25 Spots available for Professional
10 Spots available for Amateur
10 Spots available for Corporate
A waiting list will be compiled in case a team drops out. Team locations at the event are determined by the event directors.
I ALSO UNDERSTAND THIS EVENT IS RAIN OR SHINE AND NO REFUND OF THE ENTRY FEE WILL BE GIVEN. ______(initial)
I UNDERSTAND THAT AS TEAM CAPTAIN, I WILL NEED TO ATTEND A PRE-EVENT SAFETY MEETING TO PARTICIPATE. ______(initial)
I UNDERSTAND AND AGREE TO THE COMPETITION GUIDELINES AND RULES OUTLINED BY THE EVENT DIRECTOR(S).
Team Captain Signature______
Total Enclosed:
$ All checks made payable to: Louisiana Culinary Enterprises, Inc.
**Credit Card Payment is available by calling Mark Falgout at 337-344-4441
Mail Registration & Entry Fee to:
Patrick Mould, Event Director
THE Louisiana Boil-Off
520 Cedar Crest CT.
Lafayette, LA 70501
Phone: 337-739-9404
E-mail:
2017 THE Louisiana Boil-Off | Team Participation & Liability Waiver
Company/Corporation/Individual:
______(Print Name)
Team Captain: ______
Team Member #1______
Team Member #2______
All cooking team participants must sign this form in order to participate in the 2017 The Louisiana Boil-Off to benefit Boys & Girls Clubs of Acadiana.
COMPLETED FORMS MUST BE SUBMITTED TO EVENT DIRECTOR BY MARCH 15, 2017.
I fully understand that my participation in the 2017 THE Louisiana Boil-Off Competition is voluntary. I further understand that, as with any event of this nature, the potential for injury exists. I understand that I should not participate in the 2017 Louisiana Boil-Off unless I am medically able to do so.
I understand that THE Louisiana Boil-Off and all of those entities' officers, directors, volunteers, employee agents and/or other representatives are hereinafter collectively referred to as the "Released Parties." By signing this for hereby specifically agree that the "Released Parties" shall not be liable for any loss, damage, injury or death arising from in any way related to my participation in the 2017 THE Louisiana Boil-Off, even if such loss, damage, injury or death is caused, in whole or in part, by the negligent acts and/or omissions of the "Released Parties."
I hereby specifically assume all such risks fully and completely. I also give permission to the "Released Parties" for the use of my name, likeness and record of my participation for a legitimate purpose, including specifically (but not limited to) for use in materials relating to publicity, advertising and me relations.
INWITNESS WHEREOF, this Agreement has been duly executed by both parties, hereto as of the day and year written below.
THE Louisiana Boil-Off AUTHORIZED SIGNATURE:
PRINTED NAME:______
SIGNATURE:______DATE:______
PARTICIPANT – TEAM SIGNATURES:
TEAM CAPTAIN
PRINTED NAME:______
SIGNATURE: ______
COMPANY: ______DATE: ______
PARTICIPANT #2
PRINTED NAME:______
SIGNATURE:______DATE:______
PARTICIPANT #3
PRINTED NAME:______
SIGNATURE:______DATE:______
Please submit this waiver to: or mail 520 Cedar Crest CT., Lafayette, LA 70501.