Participant Form

Contact Name

Marching Unit's Leader's Name

Marching Unit Name

Mailing Address

City State AK AL AR AZ CA CO CT DE DC FL GA HI ID IA IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VT VA WA WI WV WY Zip

Contact Email Address

Contact Phone Number(Numbers Only)

How Many Participants in your group? 1 - single person 2-10 (small) 11-30 (medium) 31-75 (large) 76+ (very large)
How many vehicles will you be bringing and what size are they? 0 1 small car or truck 2-4 small cars or trucks or 1 large flat bed/trailer 1 large flat bed/trailer or Float 1 Emergency Vehicle (non-fire engine/truck) 2-4 Emergency Vehicles (non-fire engine/truck) 1 Fire Engine/Truck 2-4 Fire Engines/Trucks None of the above - comment provided below
Other vehicle type
Please provide a brief description of your group to be read by our announcer In consideration of the acceptance by the St. Patrick's Day Parade Committee of the entry of the undersigned in the St. Patrick's Parade in the Borough of Somerville on March 13, 2011 the undersigned does hereby release and forever discharge the said St. Patrick's Day Parade Committee, the Borough of Somerville and their officers, representatives, successors or assigns of and from all manner of actions, and action, causes, and cause of action, suits, debts, trespass, damages and injuries which may be sustained to equipment or personnel as a result of it's participation in activities in conjunction with the Somerville St. Patrick's Day Parade in the Borough of Somerville and does hereby further covenant and agree to hold harmless and defend, to indemnify and keep indemnified the St. Patrick's Day Parade Committee and Borough of Somerville its successors, or assigns and to hold and save them harmless from and against all claims and damages whatsoever as a result of said participation. I AGREE Please make a selection.