READ THIS BEFORE COMPLETING THE FORM BELOW
This is a volunteer activity and if any family member or I are harmed in any way during this activity, I will not hold Big Country Good Neighbor Day, Kim Austin or Kim Austin State Farm legally responsible for the risks involved in this volunteer activity.
I understand photographs will be taken during the activity and I hereby grant Big Country Good Neighbor Day / Kim Austin State Farm the absolute right to use my likeness, as well as the likeness of my family members present, in the photographs / videos captured at this time for use in social media posts and advertising.
If I am bringing children other than my own, I will be responsible for the parents of the child(ren) to complete this form.
Please select the “I Agree” or the “I Disagree” button on the form below before submitting the form.