Fall-Fest 2023 Registration

Please complete the following form to register for the 2023 Fall-fest event in Wooster. Please note that all children under the age of 18 need to be accompanied by a responsible adult with parent/guardian consent if that adult is not the child’s legal guardian. Please complete a separate registration form for each attendee.

Please note that this registration form does not include a room at the hotel. Please see the hotel information to reserve your hotel room either on the web or by phone.

Registration Form

Contact Information:

First Name (required):

Last Name (required):

Street Address 1 (required):

Street Address 2:

City (required):

State (required):

Zip Code (required):

Phone (required):

Is it okay to use this number for texting?

Email Address:

What is the best way for event organizers to reach you should they need to communicate any information leading up to the event?

TextEmailPhone Call

Are you 18 or older?

What is the name of the responsible adult that you will be with? (required):

Phone Number (required):

Is this person your legal guardian?

What is the name of your legal guardian? (required):

Legal Guardian Phone Number (required):

Will you be bringing any children participating in this event who are under the age of 18?

Please list their names.(required):

By checking this box, I verify that I am either the parent or legal guardian of the child/children that I am bringing to this event, or I have obtained consent from that child’s legal guardian. I understand ACBOhio is not responsible for verifying parental consent for the participation of any persons under the age of 18, but they may seek verification at any time based on their sole discretion. I also understand and acknowledge that ACB Ohio, the Lion’s Club, and other event participants are not responsible for the safety and supervision of children during the duration of this event, and all children must be accompanied by a parent, legal guardian, or responsible adult designated and consented by the parent or legal guardian.

I agree

Please check all that you are interested in:

Friday Night ReceptionWoosterfest on Friday eveningFishing at Izaac Walton League (Saturday morning)Hiking at Izaac Walton League (Saturday morning)Woosterfest Saturday afternoonGroup dinner at a local restaurant (Saturday eveing)Woosterfest Saturday eveningHiking and picnic at Secrest Arboretum (Sunday afternoon)Board or card games in the hotel (throughout the weekend)

Which of the following best describes you?

Blind or visually impaired participantSighted participantVolunteer guide or driver

How will you be traveling to the event?

Rental van driven by volunteerGreyhound/public busDriving/personal transportationLocal participant not staying in the hotel

Do you use a guide dog?

Do you use a wheelchair or other mobility aids that will require extra room consideration for transportation?

Health Information

Please describe any food allergies, dietary restrictions, or special diets you have. (optional):

Please describe any relevant medical information that the planning committee and volunteers need to be aware of, such as bee sting or other severe allergies, asthma, diabetes/blood sugar concerns, or mobility restrictions. (optional)

Emergency contact person (required)

Relationship (required)

Phone Number (required):

Needed Assistance

Will you need assistance with transportation to/from the Greyhound stop in Wooster?

What is your arrival time Friday, and departure time Sunday?

Would you like to be considered for financial assistance?

Are you interested in assistance with finding a roommate?

Are you interested in assistance with obtaining transportation

If you answered “yes” to any of the last three questions above, please contact Katie Fredrick at:
katiefred@gmail.com
(419) 306-3721
On mobile, text.

Acknowledgements

Please read the following statements and indicate your agreement by checking the box below.
I verify that I am the participant or participant’s legal guardian. I verify that all information on this form is accurate to the best of my knowledge. I here by release ACB-O and all other sponsoring members, agents, volunteers, employees, or any other person officially connected with ACB-O activities (the providers) from any duty of care toward me associated with activities connected with the event.
In so participating, I knowingly will assume full responsibility for risk of damage to personal property, personal injury or death arising from the event.

I understand that this release covers all aspects of the act of hiking, accommodations, travel and any and all other aspects of the event’s activities.

I understand that ACBO and its partners and volunteers are not trained medical professionals, and I agree to participate at my own risk. I also understand that ACBO and its partners are not financially responsible for any medical care in the unlikely situation that it is needed during this event.

I have read and agree to ACB-O’s code of conduct statement.

While ACB-O and the Lion’s Club will make every effort to provide financial and personal assistance, I understand that I am responsible for any financial payments, such as food, lodging, and transportation, that the organizations do not in advance agree to cover. I also understand that an individual guide or mobility care person will not always be available throughout the event, and I am responsible for undertaking only those events with which I feel comfortable doing independently or with available assistance.

I agree to all of the above statements
I agree to the above statements.