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FESTA ITALIANA
 

Grape Stomp Application & Waiver Release Form
 Sponsored by Bolla Wines of Italy

By submitting this form, I attest and verify that I am physically fit and have full knowledge of the risks involved.  I have read the entry information and rules and certify by my signature my compliance.  I hereby release OSIA Bonaventura Lodge 2814, Festa Italiana, Kootenai County Fairgrounds, and any and all individuals or companies associated with the event from responsibility for any injuries or damages I may suffer as a result of my participation in the Bolla Grape Stomp.

Team  Name
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PLAYER 1:
Name

Phone
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PLAYER 2:
Name

Phone
 Emergency Contact & Phone
 T-Shirt Size
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Address
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PLAYER 3:
Name

Phone
 Emergency Contact & Phone
 T-Shirt Size
M  L  XL  XXL
Address
 City/State/Zip


 

 

 

 
 

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