Bois D' Arc Rendezvous Registration/Release Form

In consideration of the acceptance of this registration I, intending to be legally bound, hereby for my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against the Interior Highlands Ancestral Lifeways Association or Red Willow Primitive Skills, Inc., their representatives, successors and assigns for injuries incurred by me during or because of this event. I also release any and all photos, video or other media documentation to be used for promotional purposes by the hosting entities


Print Full Name__________________________________________________

Street Address___________________________________________________

City, State, Zip Code_____________________________________________

Area Code, Phone Number________________________________________

E-mail__________________________________________________________

Signature_______________________________________________________
(Signature of parent or legal guardian if under 18 years of age)

$40/day ($50 after Sept. 15)  $100/all three days ($125 after Sept. 15)

Total: $_____________________________
Mail Check or Money Order to:  IHALA   POB 459, Strafford MO 65757