Parade Entry Application

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Krewe of Massalina

12th Annual Mardi Gras


February 4, 2012
PARADE ENTRY APPLICATION
NAME OF KREWE: _____________________________________________________________________
AFFILIATE ORGANIZATION: ____________________________________________________________
KREWE CAPTAIN OR CONTACT PERSON: ________________________________________________
HOME PHONE: __________________CELL PHONE: ________________WORK PHONE: ___________
E-MAIL ADDRESS: _____________________FAX NUMBER: __________________________________
MAILING ADDRESS: ___________________________________________________________________
____________________________________________________________________
TYPE OF ENTRIES: INCLUDE BRIEF DESCRIPITION FOR EACH; INCLUDE SIZE ( L x W )
1. ____________________________________________________________________________________
2. ____________________________________________________________________________________
3. ____________________________________________________________________________________
4. ____________________________________________________________________________________
5. ____________________________________________________________________________________
OTHER (INCLUDING AUTOS, ETC.):
I, as the representative for the above named organization, agree to indemnify and hold harmless the Krewe
of Massalina, Inc, its directors, officers, members, employees, agents, successors, and assigns from any and
all, personal injury, or damages of any type incurred by me which result from or arise out of participation in
the activities of the Krewe of Massalina Mardi Gras event. I agree to the rules and regulations governing
participation in the event and agree to abide by them.
Signature ________________________________________________ Date ________________________
Entry Fee is $25.00
RETURN THIS FORM AND YOUR CHECK TO:
P.O. BOX 347, PANAMA CITY,
FL.32404-0347
CONTACT US AT 850-913- 8383

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