Omca 2009 Entrant Form

THE 2009 OREGON MEDICAL CANNABIS AWARDS Sponsored by Oregon NORML

PO Box 16057 ● Portland, OR 97292-0057 ● (503) 239-6110 Oregon NORML is the Portland affiliate of the National Organization for the Reform of Marijuana Laws

ENTRANT’S CONTRACT REGISTRATION INDEMNIFICATION & RELEASE All Entrants must be cardholders currently registered with the Oregon Medical Marijuana Program. All Entrants shall be 18 years of age or older. Entrants must certify that his/her entry or entries are from Cannabis grown in the State of Oregon and by himself/herself. All entrants must sign Entrant’s Contract and agree to abide by the contest rules as set forth herein and in the Official Rules. Entries shall consists of one (1) ounce of dried & cured marijuana of one known strain. Entrants may submit up to four (4) strains, but each strain entry must consist of one (1) ounce (e.g. three strains = three ounces). Entrants shall pay a non-refundable Registration Fee. If only one strain is submitted, the entry fee is $50. For two strains, the entry fee is $35. If three or more strains are submitted, the entry fee is only $25. This Contract, Registration Fee, and Entries must be turned into the Organizing Committee possession no later than 5 p.m. Friday, November 6, 2009. Submissions will not be returned to the Entrant. The Organizing Committee will furnish to Entrant containers for use in packaging submission(s). Appointments will be made with Entrants for receipt of cannabis being submitted.

I, the undersigned, do hereby swear or affirm under penalty of perjury that:      

I am a cardholder currently registered with the Oregon Medical Marijuana Program and I meet the requirements listed herein. I agree to abide by the contest rules and the Entrant’s Contract. I hereby submit a signed Contract and non-refundable Registration Fee to Oregon NORML. I affirm that my entry or entries are from Cannabis personally grown in the State of Oregon I understand that a substantial breach of this contract or the rules of this event – as determined by the Organizing Committee – shall be grounds for disqualification and loss of all event privileges. If I sign this contract under false pretenses, i.e., that I am not a cardholder currently registered with the Oregon Medical Marijuana Program, I agree to be responsible for any criminal or civil penalties levied against Oregon Medical Cannabis Awards™ 2009 Organizing Committee, its officers, agents, and their heirs and assigns, and Oregon NORML, its Officers, Board Members, agents, and their heirs and assigns.

Indemnification and Release I, the undersigned, am entering into the Oregon Medical Cannabis Awards™ 2009 with full knowledge of state and federal laws pertaining to cannabis. I am doing so of my own free will. I have been afforded the opportunity to speak with an attorney of my choice and at my expense regarding my participation in this event. I hereby agree to indemnify and hold harmless the Oregon Medical Cannabis Awards™ 2009 Organizing Committee, its officers, agents, and their heirs and assigns, and Oregon NORML, its Officers, Board Members, agents, and their heirs and assigns, from any and all claims arising from my participation. I know that the criminal laws concerning cannabis include but are not limited to fines and jail and/or prison time. I freely choose to enter this event. I, the undersigned, do further irrevocably assign to the Oregon affiliate of NORML (the National Organization for the Reform of Marijuana Laws) all rights and privileges pertaining to photography and/or videography, including but not limited to publishing rights to any and all recordings. By signing this document, I certify that I meet the above criteria. Your Printed Name:

Phone Number:

Your Signature:

Date Signed:

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PLEASE FILL OUT THIS FORM COMPLETELY - ESPECIALLY THE PHONE NUMBER

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