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 accepted until the day of the event.
EACH SPOT IS 10L X 10W and teams must provide their own 10x10 pop-up tent (companybranded 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. dba The Louisiana Boil-Off
**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: [email protected]
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: [email protected] or mail 520 Cedar Crest CT.,
Lafayette, LA 70501.