CCCIA 4th Fest Parade Entry Form
Parade Entry Fees: $5/person or $20/group for CCCIA members. $10/person or $40/group for non-members. Each entry will be judged and awards will be given after the parade. The parade steps-off at 10 a.m. on Gross Dam Road.
Please read and agree to the release on bottom of the page (parents must complete for kids under 18.) Contact Tami Waltemath at with questions.

Send your payment to CCCIA 4th Fest Parade, PO Box 7331, Golden, CO 80403 or return to the website and follow the links to pay by PayPal.
Contact Person *
Group Name (if applicable)
Phone Number
Category for Judging (please select at least one) *
All 4th Fest participants must read and agree to the following
Release of Liability: In consideration of my entry being accepted, I waive any and all claims for myself, my administrators, and my heirs against all officials, sponsors, and organizations connected with the Coal Creek Canyon 4th Fest for injury or illness which directly or indirectly results from my participation in this event. CCCIA is not responsible for damages to property/self, or theft. I recognize that there are risks in participating in this event, including but not limited to dangers from vehicles, animals, other participants, and weather. I hereby assume all of the risks of participation and/or volunteering in this event. I realize that liability may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them or because of their possible liability without fault. I acknowledge that the Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the event in which I may participate, and that it will govern my actions and responsibilities at said event. In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release, and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter occur to me including my traveling to and from this event THE FOLLOWING ENTITIES OR PERSONS: Boulder County, Jefferson County, CCCIA, their directors, officers, employees, volunteers representatives, and agents, the event holders, event sponsors, event volunteers; (B) Indemnify and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this event, whether caused by the negligence of releases or otherwise. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this event. I understand that at this event or related activities I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the event holder, producers, sponsors, organizers, and assigns. The Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissibly under applicable law. I hereby certify that I have read this document: and, I understand it’s content. PARENT/GUARDIAN WAIVER FOR MINORS (Under 18 years old) The under-signed parent and natural guardian does hereby represent that he/she is, in fact, acting in such capacity and agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim, or damage whatsoever which may be imposed upon said parties because of any defect in our lack of such capacity to so act and release said parties on behalf of the minor and the parents or legal guardian.
Did you read and agree with the Release of Liability above? *
Are you under 18 years of age? *
If you are under 18 years of age, you must include the name and contact information for a parent or guardian below
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