I would like to judge this Competition

Name:

Address:

City:

State:

Zip Code:

Phone Number:

Your Email Address:

I am a KCBS Member
I am a Certified Barbeque Judge
I am a Certified Table Captain
I am a Certified Master Judge
I am a member of a cooking team

How many KCBS contest have you judged?

Contact: Tim Anderson
Northside Christian Church
4407 Charlestown Rd
New Albany, IN 47150
tanderson@mynorthside.org

Waiver of Liability
In consideration of accepting this application, I the undersigned intend to be legally bound, hereby for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages against Kansas City Barbeque Society and the Northside’s Cruzin’ Blues and BBQ Contest and their agents, successors and assignees for any and all injuries suffered by me in this event. Further, I hereby grant full permission to Kansas City Barbeque Society and the Northside’s Cruzin’ Blues and BBQ Contest and/or agents authorized by them, to use any photographs, videotapes, motion pictures, recordings or any other record of this event for any legitimate purpose.