18TH ANNUAL NAPA COUNTY PRUNING CONTEST ... Events...18TH ANNUAL NAPA COUNTY PRUNING CONTEST...
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www.farmworkerfoundation.org To Support and Promote Napa Valley’s Vineyard Workers Through Education and Professional Development 18 TH ANNUAL NAPA COUNTY PRUNING CONTEST CONTESTANT APPLICATION Saturday, February 9, 2019 9 am – 1 pm Beringer Vineyards - Gamble Ranch Deadline to enter: January 28, 2019 CONTESTANT INFORMATION Contestant Name: _____________________________________________________________________________________________________________ Vineyard/Winery: ________________________________________________________ Phone: ___________________________________________ Division participating in (please circle one): Men’s Division Women’s Division EMPLOYER INFORMATION Employer Contact Name: ____________________________________________________________________________________________________ Employer Email: _______________________________________________________ Employer Phone: __________________________________ Address: ______________________________________________________________________________________________________________________ City: __________________________________________________________ State: ____________ Zip: _______________________________________ Worker's Compensation Policy Number: ___________________________________________________________________________________ Carrier Name & Phone: _______________________________________________________________________________________________________ Policy Holder Name: __________________________________________________________________________________________________________ WAIVER FOR PRUNERS – MUST BE SIGNED BY CONTESTANT In consideration of the acceptance of my entry, I, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I have or may have against the organizers of this event, its principals, its employees, all sponsors, and their representatives and any and all claims of damages, demands, or actions whatsoever in any manner, as a result of my participation in the Pruning Contest event, including travel to and from the event. I attest and verify I am physically fit and have sufficiently trained for this event and a qualified medical person has not advised me otherwise. Further, I hereby grant full permission to any and all of the foregoing to use my name and likeness in any broadcast, telecast, video, or print media of the event without compensation to me. Contestant Signature: ___________________________________________________________________ Date: _______________________________ To enter, please return application: By Mail: Send application to 1795 Third Street, Napa, CA 94559 By Fax: Fax application to the NVG office at (707) 224-8644 By Email: Scan your application and email to [email protected]
Transcript of 18TH ANNUAL NAPA COUNTY PRUNING CONTEST ... Events...18TH ANNUAL NAPA COUNTY PRUNING CONTEST...
www.farmworkerfoundation.org
To Support and Promote Napa Valley’s Vineyard Workers Through Education and Professional Development
18TH ANNUAL NAPA COUNTY PRUNING CONTEST CONTESTANT APPLICATION
Saturday, February 9, 20199 am – 1 pm
Beringer Vineyards - Gamble Ranch Deadline to enter: January 28, 2019
CONTESTANT INFORMATION
Contestant Name: _____________________________________________________________________________________________________________
Vineyard/Winery: ________________________________________________________ Phone: ___________________________________________
Division participating in (please circle one): Men’s Division Women’s Division
EMPLOYER INFORMATION
Employer Contact Name: ____________________________________________________________________________________________________
Employer Email: _______________________________________________________ Employer Phone: __________________________________
Address: ______________________________________________________________________________________________________________________
City: __________________________________________________________ State: ____________ Zip: _______________________________________
Worker's Compensation Policy Number: ___________________________________________________________________________________
Carrier Name & Phone: _______________________________________________________________________________________________________
Policy Holder Name: __________________________________________________________________________________________________________
WAIVER FOR PRUNERS – MUST BE SIGNED BY CONTESTANT
In consideration of the acceptance of my entry, I, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I have or may have against the organizers of this event, its principals, its employees, all sponsors, and their representatives and any and all claims of damages, demands, or actions whatsoever in any manner, as a result of my participation in the Pruning Contest event, including travel to and from the event. I attest and verify I am physically fit and have sufficiently trained for this event and a qualified medical person has not advised me otherwise. Further, I hereby grant full permission to any and all of the foregoing to use my name and likeness in any broadcast, telecast, video, or print media of the event without compensation to me.
Contestant Signature: ___________________________________________________________________ Date: _______________________________
To enter, please return application:
By Mail: Send application to 1795 Third Street, Napa, CA 94559
By Fax: Fax application to the NVG office at (707) 224-8644
By Email: Scan your application and email to [email protected]
www.farmworkerfoundation.org
Para apoyar y promover Los Trabajadores de los Viñedos en el Valle de Napa através de la Educación y Desarrollo Profesional
18º CONCURSO DE PODA ANUAL DEL CONDADO DE NAPAAPLICACIÓN DEL CONCURSANTE
Sábado, 9 de Febrero, 20199 am – 1 pm
Beringer Vineyards - Gamble Ranch Inscríbase antes del 28 de enero 2019
INFORMACIÓN CONCURSANTE
Nombre de Concursante: _______________________________________________________________________________________________________
Viñedo / Bodega: _____________________________________________________________ Teléfono: ______________________________________
División de Participación (por favor marque uno): División Masculina División Femenina
INFORMACIÓN DEL EMPLEADOR
Nombre de Empleador (contacto): ____________________________________________________________________________________________
Correo Electronico de Empresa: __________________________________________ Teléfono del empleador: ________________________
Dirección: ________________________________________________________________________________________________________________________
Ciudad: _______________________________________________________ Estado: ________________ Código Postal: ________________________
Número de la póliza de Compensación de los Trabajadores: _______________________________________________________________
Nombre y Teléfono de Aseguradora: _________________________________________________________________________________________
Nombre del Asegurado: ________________________________________________________________________________________________________
RENUNCIA DEL PODADOR - DEBE SER FIRMADA POR EL CONCURSANTE En consideración de la aceptación de mi entrada, yo, para mí, mis herederos, ejecutores y administradores, renuncio y cedo cualquiera y todos los derechos y demandas por los daños que tenga o que pueda tener en contra de los organizadores de este acontecimiento, sus directores, sus empleados, todos los patrocinadores y sus representantes y cualquiera y todos las reclamos de daños, de demandas, o de acciones cualquiera y de cualquier manera, como resultado de mi participación en el acontecimiento del concurso de la poda,incluyendo viajando hacia el evento y a su retornó del evento. Atestiguo y verifico mi estado físico y he entrenado lo suficiente para este acontecimiento y una persona médica calificada no me ha aconsejado de otra manera. Además, concedo por este medio el permiso completo a cualquiera y todos los medios públicos para utilizar mi nombre y semejanza en los medios de televisión o de vídeo sin remuneración para mí.
Firma: ______________________________________________________________________________________ Fecha: ___________________________
Para participar, por favor devuelva la Aplicación del Concursante Por correo: Envíe la solicitud a 1795 Third Street, Napa, CA 94559
Por Fax: A la oficina de NVG al (707) 224-8644 Por correo electrónico: Escanear su aplicación y mande al correo [email protected]
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