Team Name:_____________________________________________________

Address:________________________________________________________

City:_______________________________ State:_______ Zip:_____________

Day Phone:______________________________________________________

Evening Phone:_________________________ Fax:_____________________ 

E-mail:_________________________________________________________

Head Cook: __________________________ No. on Team: ________________

Team Shirt Sizes:___S,___M,___L,___XL,___XXL,___XXXL

What will you be cooking?:

May Preregister (By May 25) or Register onsite Friday, June 8th at 10:00 a.m. (Limited Space Available) May start cooking after meat inspection with entries being turned in starting at 12:00 p.m. Saturday, June 9th.

Entry Fee $150.00 (Pre Register $125.00) Electricity $10.00

RV/Motorhome: _______ (Yes or No) RV/Motorhome Size__________________

Alabama Governor's Cup Entry _____ $50.00

Ronnie Miller:      Email: ronnie@therapedic-al.com Phone:205-486-5325
Bruce Eddy:        Email: bruce@rcrotorworld.com    Phone:205-486-9561
Shannon Lollar: Email: slollar@tfbank.net                  Phone:205-486-6260

Waiver of Liability: In consideration of your acceptance of this entry form and fee, I the undersigned, intending to be legally bound, do hereby for myself, my heirs, executors and administrator, waive and release all rights and claims for damages I may have against 911 Backyard BBQ, Haleyville Rotary Club, any other organizations or committees involved in the planning of this event, property owners, City of Haleyville or Winston County, their agents, successors and assigns for any and all injuries suffered to me in this event. I further grant permission to 911 Backyard BBQ Cookoff and/or agents authorized by them, to use any photographs, videotapes or any other record of this event for legitimate purpose.