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) complete this form.
Please select the “I Agree” or the “I Disagree” button on the form below before submitting the form.