Wood Glider Derby Registration

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Registration fee is $4 which covers all materials.

Contestant's Full Name *

Contestant's Nickname (if any)

Contestant's School *

Contestant's Grade *

Parent or Guardian Full Name *

Phone Number *

Email Address *

Full street address including city, state and zipcode.

Is the contestant currently a Cub Scout? If so, please list the Pack number (and the council if outside of the Baltimore area). Note: Contestants do NOT need to be Cub Scouts to participate.

Understanding of Risks *

I understand that participation in Scouting activities involves the risk of personal injury, including death, due to the physical, mental, and emotional challenges in the activities offered. Information about those activities may be obtained from the venue, activity coordinators, or your local council. I also understand that participation in these activities is entirely voluntary and requires participants to follow instructions and abide by all applicable rules and the standards of conduct.

Required

Informed Consent and Release *

I have carefully considered the risk involved and hereby give my informed consent for my child to participate in all activities offered in the program. I further authorize the sharing of the information on this form with any BSA volunteers or professionals who need to know of medical conditions that may require special consideration in conducting Scouting activities. With appreciation of the dangers and risks associated with programs and activities, on my own behalf and/or on behalf of my child, I hereby fully and completely release and waive any and all claims for personal injury, death, or loss that may arise against the Boy Scouts of America, the Baltimore Area Council, Pack 3807, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with any program or activity.

Required

Authorization of Multimedia Use *

I hereby assign and grant to Pack 3807, the Baltimore Area Council and the Boy Scouts of America, as well as their authorized representatives, the right and permission to use and publish the photographs/film/ videotapes/electronic representations and/or sound recordings made of me or my child at all Scouting activities, and I hereby release the Boy Scouts of America, the Baltimore Area Council, Pack 3807, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all liability from such use and publication. I further authorize the reproduction, sale, copyright, exhibit, broadcast, electronic storage, and/or distribution of said photographs/film/videotapes/electronic representations and/or sound recordings without limitation at the discretion of the BSA, and I specifically waive any right to any compensation I may have for any of the foregoing.

Required

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