Halloween Hullabaloo
Pumpkin Chunkin’ Contest
Registration Form
Registration Deadline: October 21 at 9:30pm
Put your skills to the test at this year’s Halloween Hullabaloo as the DRC has added a pumpkin chunkin’ contest. Get a team together and build a catapult or trebuchet and see who can launch their pumpkin the farthest!
Check-in begins at 9:30am, with a safety check and pumpkin weighing at 10:30am. The competition will begin
at 11:30am.
Saturday, October 24, 2015
9:30am check in
11:30am Competition begins
Entry Fee: $25.00
High Park: 2801 E. James St. Derby, Kansas 67037
1st Prize: $200.00
Team Name : ___________________________________Machine Name: ____________________________________
Team Captain Name: ______________________________________________________________________________
Captain’s Address: _______________________________City/State/Zip: _____________________________________
Captain’s Phone: _________________________________ Captain’s Email: ___________________________________
Payment must be included with this form. Please make checks payable to Derby Recreation Commission.
Mail to: DRC, PO Box 324, Derby, Kansas 67037
By signing and submitting this application, you are acknowledging that you have read and will adhere to the official competition rules, as stated on
the attached sheet.
Waiver for Participant
In consideration of your accepting this entry, I hereby, for myself, an child, my heirs, executors and administrators, waive and release any and all
rights and claims for damages I or my child may have against the Derby Recreation Commission, City of Derby or USD 260 and its representatives,
successors and assigns for all injuries suffered by myself or my child at any activity sponsored by these groups.
Captain’s Signature: _________________________________________________ Date: ________________
For questions please contact Jennifer Nixon, Special Events Coordinator at 316-529-2677 or [email protected]