SCENIC GALVESTON
RIVER, LAKES, BAYS ‘N BAYOUS TRASH BASHTM

As a participant, or parent or guardian of a participant in the River, Lakes, Bays ‘N Bayous Trash Bash sponsored by the Texas Commission on Environmental Quality and other participating sponsors, I, undersigned, hereby release, discharge, and agree to hold harmless the State of Texas, the Texas Commission on Environmental Quality, all other sponsors, their agents, employee, officers, and successors from all liability, claims or actions which I, my heirs, executors, administrators, or assigns may have or claim to have against any of them arising from any persona injuries or other claims connected therewith, whether known or unknown, or injuries to other persons or to property caused by or arising out of any actions I might take relating to my activities while participating in the above event.

If the participant is a minor, I, as parent or guardian of the participant, further authorize participating sponsors and employees of these organizations to obtain emergency medial treatment for the participant, should an apparent need for this treatment arise.

I have carefully read this release and understand all its terms.  I accept the terms voluntarily and with full knowledge of its legal consequences.

Club, Group or Company (where applicable)
*Birth Date of Participant
Parent or Guardian Name (where applicable)
*Participant's Name (please print)
*Emergency Phone # (should need arise)
*Street Address
*City
*State
*Zip Code
I grant permission to photograph, record, broadcast and otherwise use in any media, including web pages or the internet, my or my child's participation in Trash Bash and to use my name, voice, and biographical information  concerning me in connection therewith.
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