Registration for Iowa Author Fest
September 26th, 2015 Saturday
9:00 A.M. to 2:00 P.M.
Brenton Skating Plaza
Robert Ray Drive, Des Moines, Iowa

Name:____________________________________________________

Address: __________________________________________________

___________________________________________________

___________________________________________________

E-mail:___________________________________________________
Phone Number:____________________________________________
Genre:___________________________________________________
_________________________________________________________
Other contact Information:__________________________________
Liability Waiver and Release
In agreeing to participate in Iowa Author Fest, I, __________________________ along with all my associates in my Author’s booth, hereby waive, release and forever discharge the organizers, its members, volunteers and all other individuals and entities in any way assisting or connected with this event from any and all claims, loss, damage liability and all liability of whatever kind or nature whatsoever arising out of my participation in this event.
Fee: $20.00
Deadline: August 15th, 2015Remit your payment to:
Larry Stumbo
6120 Urbandale Ave.
Des Moines, Iowa 50322
E-Mail: B2013K@outlook.com

We have limited space. Tables and chairs not provided.