Diaper Derby Entry Form
Saturday, April 28, 2018
Lebanon Valley Mall
Preliminary Crawl Offs begin at 11:00AM, with finals in the early afternoon!
Limited to the first 54 entries
Parent/Guardian name: *
Baby name: *
Baby's age (as of 4/28/18): *
Phone number: *
Address: *
City: *
Zip: *
Email address: *
Disclaimer:
Parents or guardians of contestants authorize the release of his or her baby's photograph to sponsors of this event for use in advertising purposes relating to the contest. No compensation shall be paid.
The parent or guardian shall release sponsors of this event from all claim actions, liabilities and expenses in connection with personal injury to their child while participating in the Four-On-The-Floor Diaper Derby.
*
Required
Contest Rules:
1. Babies must crawl entire distance.
2. All prizes must be accepted as awarded. Cash or substitutions will not be allowed.
3. Judges decision regarding contest winner is final.
4. Contest is open to the residents of Lebanon Valley with the exception of sponsors, their employees or members of their immediate families.
5. All contest entry forms become the property of Lebanon Valley Mall.
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