TxSWANA. Houston, Texas. June 26 th and 27 th. Registration Packet. Sponsored by the City of Houston and Republic Services

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1 2015 TxSWANA ROAD-E-O Houston, Texas June 26 th and 27 th Registration Packet Sponsored by the City of Houston and Republic Services

2 2015 TxSWANA Lone Star Chapter Road-E-O WAIVER OF LIABALITY AND RELEASE AND INDEMNIFICATION AGREEMENT I, hereby request the opportunity to participate in the (Name of Participant) (Type of Equipment) Road-E-O Program sponsored by the SWANA Lone Star Chapter ( Sponsor ) in Houston, Texas on June 27, WHEREAS, the Solid Waste Association of North America and the Sponsor, their respective agents, employees, and officers (hereinafter referred to as SWANA ) consents and agrees to permit (hereinafter referred to as PARTICIPANT ), to participate in the Road-E-O Program, subject to the adherence of the PARTICIPANT to any provisions set out in the rules and regulation of SWANA. NOW, THEREFORE, FOR AND IN CONSIDERATION OF THE PREMISES AND THE MUTUAL PROMISES, COVENANTS, AND AGREEMENTS SET FORTH IN THIS AGREEMENT, THE SWANA AND PARTICIPANT AGREE THAT THE SWANA, THE CITY OF HOUSTON, REPUBLIC SERVICES, THEIR RESPECTIVE AGENTS OR EMPLOYEES, SHALL NOT BE LIABLE OR RESPONSIBLE FOR AND SHALL BE SAVED, HELD HARMLESS, RELEASED, DEFENSED, AND INDEMNIFIED BY PARTICIPANT FROM AND AGAINST ANY AND ALL CLAIMS, SUITS, ACTIONS, LOSSES, DAMAGES, OR LIABILITY OF ANY CHARACTER, TYPE, DESCRIPTION, INCLUDING BUT NOT LIMITED TO ALL EXPENSES OF LITIGATION, COURT COSTS, AND ATTORNEY FEES FOR INJURY OR DEATH TO ANY PERSON, OR INJURY TO ANY PROPERTY ARISING OUT OF, OR OCCASIONED BY, DIRECTLY OR INDIRECTLY, THE PARTICIPATION OF PARTICIPANT IN THE ROAD-E-O PROGRAM, INCLUDING CLAIMS AND DAMAGES ARISING IN WHOLE OR IN PART FROM THE NEGLIGENCE OF THE SWANA, THE CITY OF HOUSTON, REPUBLIC SERVICES, AND/OR THEIR RESPECTIVE AGENTS OR EMPLOYEES. IT IS THE EXPRESSED INTENT OF THE PARTIES TO THIS AGREEMENT THAT THE INDEMNITY PROVIDED FOR IN THIS AGREEMENT IS AN INDEMNITY EXTENDED BY PARTICIPANT TO INDEMNIFY AND PROTECT THE SWANA, THE CITY OF HOUSTON, REPUBLIC SERVICES, AND/OR THEIR RESPECTIVE AGENTS OR EMPLOYEES, FROM ANY AND ALL CLAIMS FOR ACTIONS, AS SET FORTH ABOVE, OF ANY KIND, ARISING DIRECTLY OR INDIRECTLY FROM THE PARTICIPATION OF PARTICIPANT IN ROAD-E-O PROGRAM, REGARDLESS OF WHETHER SUCH CLAIMS OR ACTIONS ARE FOUNDED IN WHOLE OR IN PART UPON ALLEGED NEGLIGENCE OF SWANA, THE CITY OF HOUSTON, REPUBLIC SERVICES, AND/OR THEIR RESPECTIVE REPRESENTATIVES, AGENTS, OR EMPLOYEES. It is further understood and agreed that the PARTICIPANT will participate solely as an individual on a voluntary basis and not as an employee, contractor, or agent of the SWANA or its agents or employees. Individuals who are employed by SWANA acknowledge that this participation is outside the scope of their employment and is performed on a voluntary basis only. In making this Agreement, PARTICIPANT relies wholly upon his/her own judgment, belief and knowledge and has not been influenced to any extent whatsoever by a representations or statement not contained in this Agreement. I, the undersigned, do hereby consent to and authorize the use of any photographs taken of the participants listed below by the SWANA, any sponsor, or their contractors for the purpose of developing public information materials. I understand that participation in the Road-E-O Program involves certain inherent risks and potential hazards which I have considered and which I knowingly assume. I have read this Waiver of Liability and Release and Indemnity Agreement, and fully understand all of its terms. I understand that I have given up substantial rights by signing it, and have signed it freely and voluntarily without any inducement, assurance, or guarantee being made to me and intend my signature to be complete and unconditional release of all liability to the greatest extent allowed by law.

3 JUDGE/VOLUNTEER SIGN-UP FORM We greatly appreciate the time and support given by our event volunteers and judges. To participate in the 2015 TxSWANA Road-E-O as a judge or to help support the competition as a volunteer, complete the information below and return to the address included by May 28. The 2015 event will be held in Houston, Texas, Saturday, June 27. This form must be completed by all volunteers/judges. Please sign up by May 28. Sign-Up Information (please print) Name (First, Last): Employer: Mailing Address: City/State: ZIP Code: Phone: Fax: Judge/Volunteer Registration Judge: Truck Landfill Judges and volunteers will be provided transportation from the event hotel to the Road-E-O, and admission to the awards banquet. Everyone registering as a judge or volunteer will also receive a 2014 TxSWANA Road-E-O T-shirt. Please note your T-shirt size S M L XL XXL (2X) XXXL (3X) Guest Registration Guest registration is $40 per adult and covers meals, transportation to/from events, and the Awards Banquet. A ticket will not be provided without the following guest information. Guest Name: Total Registration Fees (make checks payable to TxSWANA) TxSWANA Use Only: Reg. Recv d: Guest Registration: $40 x Check: Child Registration (6-12) $20 x (free under age 6) Total Enclosed: $ LIABILITY RELEASE I,, hereby request the opportunity to participate as a JUDGE or VOLUNTEER in the TxSWANA Road-E-O at the Republic Services Whispering Pines location or at the City of Houston Northeast Service Center location on June 26 and 27, I AGREE THAT THE SWANA, THE CITY OF HOUSTON, REPUBLIC SERVICES, THEIR RESPECTIVE AGENTS OR EMPLOYEES, SHALL NOT BE LIABLE OR RESPONSIBLE FOR AND SHALL BE SAVED, HELD HARMLESS, RELEASED, DEFENSED, AND INDEMNIFIED BY PARTICIPANT FROM AND AGAINST ANY AND ALL CLAIMS, SUITS, ACTIONS, LOSSES, DAMAGES, OR LIABILITY OF ANY CHARACTER, TYPE, DESCRIPTION, INCLUDING BUT NOT LIMITED TO ALL EXPENSES OF LITIGATION, COURT COSTS, AND ATTORNEY FEES FOR INJURY OR DEATH TO ANY PERSON, OR INJURY TO ANY PROPERTY ARISING OUT OF, OR OCCASIONED BY, DIRECTLY OR INDIRECTLY, THE PARTICIPATION OF PARTICIPANT IN THE ROAD-E-O PROGRAM, INCLUDING CLAIMS AND DAMAGES ARISING IN WHOLE OR IN PART FROM THE NEGLIGENCE OF THE SWANA, THE CITY OF HOUSTON, REPUBLIC SERVICES, AND/OR THEIR RESPECTIVE AGENTS OR EMPLOYEES. I have read this RELEASE and understand all of its terms, and execute it voluntarily. APPLICANT SIGNATURE: DATE: 2015 TxSWANA road-e-o I prefer to participate as a judge/volunteer in the: TRUCK Competition LANDFILL EQUIPMENT Competition GENERAL EVENT * While TxSWANA cannot guarantee placement preference, we will try to place volunteers as requested. Return Address: City of Houston Solid Waste Management Department 611 Walker, 12 th Fl. Houston, Texas Registration Questions? Contact Carroll Hill at Carroll.Hill@houstontx.gov Sign up by May 28, There will be no refunds for cancellations.

4 PARTICIPANT SIGN-UP FORM Participant Sign-Up Information Name(First, Last): Employer: Mailing Address: City: State: Zip: Business Phone: Business Fax: Are you or your employer a SWANA member? Yes No Length of employment: The employee has been employed as a driver/operator for the last Equipment employee frequently operates (type/manufacturer): includes one guest. TRUCK LANDFILL Rear Loader Roll-off Compactor Front Loader Transfer Tractor/Trailer Dozer Automated Side Loader Scraper months. Select your T-shirt size: S M L XL XXL (2X) XXXL (3X) Competition Category (check only one) Entry Fee is $150. The fee includes meals, transportation to/from events, and the Awards Banquet. The fee MECHANIC Truck Landfill Guest Registration (employees, spouses, children, friends, etc.) Guest Registration is $40 per additional guest (one guest is included in the entry fee). Guest registration covers meals, transportation to/from events, and the Awards Banquet. A ticket will not be provided without the following guest information: Guest Name: Guest Name: Total Registration Fees (make checks payable to TxSWANA) Position: Road-E-O Registration Fee: $150 Guest Registration: $40 x Child Registration (6-12) $20 x (free under age 6) Total Enclosed: $ In order to register for this event, participants must be accident free in the work place for (1) full year and listed in a non-supervisory position. TxSWANA Use Only: Reg. Recv d: Check: Registration Questions? Contact Carroll Hill at Carroll.Hill@houstontx.gov Sign up by May 28, There will be no refunds for cancellations.

5 2015 TxSWANA Road-E-O Participant Questionnaire Please complete this form and submit with registration form Participant Name: Employer Name: How long have you been with your employer? How many years have you competed in the Road-E-O? Please tell us more about yourself: (i.e. hobbies, sports, music, favorite food, family, etc.) The information provided on this form will be communicated as the participant maneuvers through the course and/or will be announced at the banquet. Complete this form and submit it by fax to (713) ; or mail to Carroll Hill c/o City of Houston Solid Waste Department, 611 Walker 12 Fl. Houston, TX or scan and to

6 HOTEL ACCOMODATIONS The 2015 TxSwana Road-E-O will be using the following hotels for all participants and guests. All reservations must be made by contacting the hotel directly and are subject to availability. Please make your reservations promptly to avoid availability issues TxSWANA ROAD-E-O If you need further information regarding hotel accommodations, contact Carroll Hill at Houston, Texas PRIMARY HOTEL $79 Single Room $89 Double Room Holiday Inn Intercontinental Airport JFK Blvd. Houston, TX OVERFLOW HOTEL $84 Single Room $94 Double Room Interwood Suites Intercontinental Airport 4015 Interwood N. Pkwy Houston, TX

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