Name of primary contact *

First Name

Last Name

Cellphone number *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

In the parade, my group/krewe will be moving via... *

Check all that apply

Bicycle

Power wheels

Golf cart

Scooter

Wagon

Skateboard

Wheelchair

Roller skates/blades

Walking

Waiver (please check both) *

By checking this box, I understand and give my permission for the child(ren) above to participate in the “Pascagoula Children’s Parade” on Saturday, February 3, 2024. I understand that all children must be checked in at the parade forming area by an adult and picked up by that same adult under the tent at the green space on Delmas Avenue and Magnolia Street. I recognize that there are certain risks to participation in the parade and the parade sponsors are only responsible for reasonable supervision. I understand that the parade sponsors do not assume liability extending beyond that point.