LSSA Trivia Night- Faculty & Staff Teams
Date: Monday, October 24th, 2022
Time: 6:30 to 8:30 p.m. (doors open at 6)  
Location: Giant Jones Brewing Company, 931 East Main Street, Suite 9 (Enter on South Brearly Street)
Questions? Email Elizabeth at eajohnson29@wisc.edu

Tables are sold on a first-come, first-served basis.
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List your team members' names below (4 to 6 members)
Teams do not need to be finalized at the time or registration.
Name *
Please select one team member to be your point of contact and provide their name and contact information. It is not necessary to provide contact information for all team members.
Email *
Phone Number *
How to Pay
The cost of a faculty/staff/alumni table is $80-$120, depending on team size ($20 per person).
*Registration is not complete until a ticket payment is made.

To pay electronically, please proceed to the La Follette School Student Association's Venmo account below.
https://venmo.com/La-Follette-SA 

If you are paying with check, please address the check to La Follette School Student Association c/o Steven Kulig
1225 Observatory Dr., Madison, WI 53706

You may also pay in person with cash at the event. 

*All tickets are non-refundable. If you purchase a ticket and are unable to attend, please contact Elizabeth Johnson at eajohnson29@wisc.edu to cancel as there will likely be a wait list for this event.
Would you like to make an additional donation to LSSA? Donations will be used for the student reception following 2023 graduation.   *
Payment Method *
Agreement to Hold Harmless, Indemnity and Release:
In consideration of permission for me to voluntarily participate in LSSA Trivia Night, today and on all future dates, I, for myself, my heirs, personal representatives or assigns, agree to defend, hold harmless, indemnify and release, the La Follette School Student Association (LSSA), and their officers, employees, agents, and volunteers, from and against any and all claims, demands, actions, or causes of action of any sort on account of damage to personal property, or personal injury, illness, or death which may result from my participation in the above-listed program.  This release includes claims based on the negligence of La Follette School Student Organization, and their officers, employees, agents, and volunteers, but expressly does not include claims based on their intentional misconduct or gross negligence.  I UNDERSTAND THAT BY AGREEING TO THIS CLAUSE I AM RELEASING CLAIMS AND GIVING UP SUBSTANTIAL RIGHTS, INCLUDING MY RIGHT TO SUE.
On behalf of myself and team members, I agree to the above clause (Hold Harmless, Indemnity and Release). *
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