Please read and agree to the following: Applicant hereby fully releases the Skokie Park District, the Village of Skokie, the Independent Merchant's of Downtown Skokie (IMODS), the Skokie Chamber of Commerce, their officers, agents and employees from any and all claims from injuries including death, damages or loss, which he/she or the organization or company they represent may have or which may accrue to them in connection with Skokie's Backlot Bash to be held August 23 – 25, 2013. Applicant further agrees to indemnify and hold harmless and defend the Skokie Park District, the Village of Skokie, the Independent Merchant's of Downtown Skokie (IMODS), the Skokie Chamber of Commerce, their officers, agents and employees from any and all claims resulting from injuries, including death, damages and losses, but not limited to the general public, which may arise or may be alleged to have arisen out of, or in connection with Skokie's Backlot Bash to be held on August 22– 24, 2014. I have read the above and agree to comply with the guidelines. I understand that failure to do so may result in removal of my display, forfeiture of application fee and/or bill for damages. I have also received, read and agree to abide by the rules and guidelines stated in Skokie's Backlot Bash event guidelines.

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