Independence
555 S Main St; PO Box 7
Independence, OR 97351
503-838-1212
503-606-3282
independencegoesdark@gmail.com
BREW FEST
1 Select
Cost: $15.00
Notes:

Price includes:

Brew Festival mug and 4 tokens.

These tokens can be used for 4 tastings or one glass. Additional tastings can be purchased within the event.

If you buy at the door it will be 20.00.

*A Printed Confirmation Page will be required to enter the event.*

Registration Information
First Name:*
Last Name:*
Address:*
City:*
State:*
Zip:*
Phone:*
Email:
Emergency Contact:
Emergency Phone:
Are you atleast 21 years of age?:*

Terms and Conditions

In Consideration of City of Independence granting permission to the undersigned the right to participate in the above activity, I hereby waive all claims for damage or loss to my person and property which may be caused by any act, or failure to act, of City of Independence, its officers, agents, volunteers, or employees in connection with the above-named activity. I assume the risk of all dangerous conditions that may be involved in participating in the above-named activity and waive any and all specific notice of the existence of any such condition.

I, for myself and for my heirs, legal representatives, and assigns, in consideration of allowing me to participate in the above-named activity, covenant with City of Independence its heirs, officers, agents, volunteers, or employees, to never institute any suit or action at law or in equity against City of Independence its officers, agents, volunteers, or employees, by reason of any claim I may have that arises out of my participation in the above-named activity.

I, for myself and for my heirs, legal representatives, and assigns, do hereby release, acquit, and forever discharge City of Independence, its officers, agents, volunteers, or employees and each of them for and from any and all claims, cause of action, suits, damages, injuries, and liabilities of every kind and nature, known or unknown, arising out of my participation in the above-named activity.

I agree to the Terms and Conditions
HACKER SAFE certified sites prevent over 99.9% of hacker crime.