POP Kids Parade Sign Up - Williamsburg Farmers Market

Child's Name*

First Last

Age*

Please enter a number from 4 to 12.

Children ages 4 - 12

Parent/Guardian Name*

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Emergency Contact Phone Number

Parent/Guardian Email

Emergency Contact Name*

First Last

Parent/Guardian Cell Phone

Consent to Participate*

I hereby certify that I am the adult parent or guardian and I consent to his/her participation in the Williamsburg Farmers Market POP Kids Parade.

The parent/guardian acknowledges and recognizes there are inherent risks involved in certain activities and the undersigned and my child assume the risk of any injury sustained during this activity. The undersigned agrees to indemnify, defend and hold harmless its agents and employees from any claims arising out of my child’s participation in any program or activity sponsored by the Williamsburg Farmers Market, even if such claim arises as a result of a negligent act or omission of or its agents and employees.

Photograph Waiver Form*

I give consent for myself or my child to be photographed, videotaped, or filmed while participating in this activity and for the resulting images to be used for promotional purposes.

The parent/guardian acknowledges and recognizes participation in the Williamsburg Farmers Market POP Kids Parade is an event where photography will take place. Consent is given for photos to be used by Williamsburg Farmers Market.

Would you like to subscribe to our POP Club newsletter?

Our POP newsletter will come out once a week to let you know what the Two Bite, activity, and story of the week will be.

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