[WestMALocals] Fwd: [WMAPage] WMass SEPT. 24 DC BUS INFO

[Owen Broadhurst]

---------- Forwarded message ----------
From: Wmass Mobe <wmassmobe at hotmail.com>
Date: Aug 16, 2005 10:28 PM
Subject: [WMAPage] WMass SEPT. 24 DC BUS INFO
To: AriseAction at yahoogroups.com, WMAPage at yahoogroups.com


WE'RE READY TO ROLL: S24 BUS INFO [Please forward widely.]
=========================
The Western Mass. September 24 DC Mobilization is ready to begin selling bus
tickets, which will be mailed upon receipt of payment. Departure times and
locations TBA.

For more information, phone 413-587-0059 (Northampton), or email
wmassmobe at hotmail.com

* Ticket cost: $65 per seat

* Make checks or money orders payable to "Western Mass. Mobilization" and
mail them to WMass Mobe, Post Office Box 2733, Springfield, MA 01101. Please
make certain your name, mailing address and phone number appear on your
check or money order; if it doesn't, please be sure to provide this
information. If you are purchasing more than one ticket, please include
names and contact information of others travelling with you. NB: No
electronic forms of payment (Pay Pal, etc.) can be processed; please do not
send cash.

* Those younger than 18 years of age should be accompanied by a parent,
legal guardian or other adult. If applicable, please sign and send the
consent form below with payment. (Our thanks to Atty. Charles Jenks of
Traprock for developing this document.)
-----------------------------------------------------------
Supervision of Minors, Waiver of Liability and
Certification by Parent or Legal Guardian
for the WMass September 24 DC Mobilization

Persons under 18 years of age must be accompanied by a parent or legal
guardian. Such parent or guardian must accompany the person under 18 on the
round trip bus ride and must supervise the person under 18 during any bus
stops and while they are in Washington, D.C.

I, _________________________________, certify that I am eighteen years of
age or older, and I am the parent or legal guardian of
______________________________, (person), who is under the age of 18,
residing at
_______________________________________________________________________, and
take full responsibility for this person's safety. I will accompany this
person on the bus for the round trip between Massachusetts and Washington,
DC, and I will supervise this person during the entire trip, including the
bus ride, any stops, and time spent in Washington, DC, including the march
and rallies.

I agree to indemnify, hold harmless and defend all organizers of this trip
from any liability for negligence arising out of this trip, including the
time spent on the bus, any stops, and the time spent in Washington, DC.

I will make certain that the person is on the bus after any stops and for
the return trip from Washington, DC. If the person is not on the bus, and
time has arrived for the bus to leave, I shall stay in the locale and take
full responsibility for finding the person and ensuring the person's safety.
Under no circumstances may I hold any said organizers liable for leaving
without myself and the person on board, and I agree to indemnify, hold
harmless and defend all said organizers from any liability that may arise
out of their leaving on the bus without the person and myself on board.

I hereby certify under the pains and penalties of perjury that all facts
recited above are true and I hereby agree to all provisions set forth above,
as a necessary condition of myself and my child or ward participating on
this round trip to Washington, DC for the march and rallies on September 24.

Signed this ___________ day of _____________, 2005 by

_________________________________
Name
_________________________________  ______________________________________
Street Address, with any apt. number,          City or Town,
   STATE,  zip code

_________________ ________________,   _________________________________
Telephone Number(s) email if available

Name, Address and Phone number of emergency contacts:
1. ________________________________Phones (____)_________ , (____)
__________
2. ________________________________Phones (____)_________ , (____)
__________
-----------------------------------------------------------

ALL OUT FOR SEPT. 24 IN DC!

_________________________________________________________________
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