Bois D' Arc Primitive Skills Gathering and Knap-In Registration/Release Form

In consideration of the acceptance of this registration I, intending to be
legally bound, hereby for my heirs, executors and administrators, waive and
release any and all rights and claims for damages I may have against the
Interior Highlands Ancestral Lifeways Association, their representatives,
successors and assigns for injuries incurred by me during or because of this
event. I also release any and all photos, video or other media documentation
to be used for promotional purposes by the hosting entities
ｩ

Print Full Name__________________________________________________

Street Address___________________________________________________

City, State, Zip Code_____________________________________________

Area Code, Phone Number________________________________________

E-mail__________________________________________________________

Signature_______________________________________________________
(Signature of parent or legal guardian if under 18 years of age)

$50/day, $120/weekend

Total: $_____________________________
Mail Check or Money Order to: 
IHALA
104 N. Arrowhead Rd.
Willard, MO 65781