Anchor City Cook-Off “One-Bite Wonder” Contest Entry Form At the City Square • Centralia, Missouri • FRIDAY, October 10, 2014 Chef’s Name _______________________________________ Team Name _______________________________________________ Address _____________________________________________________________________________________________________ City/State/Zip ___________________________________________________ Day Phone ___________________________________ Evening Phone ___________________________________ E-mail ______________________________________________________ Return this Form & Entry Money to: Centralia Area Chamber of Commerce P.O. Box 235 • Centralia, MO 65240 Questions: Ginny (573) 682-2272 or ginny@centraliamochamber.com Categories and turn in times Entry(s)......................................................................7:00 p.m. Turn in Location - Friendship Place REGISTRATION FEES Entry $ 10.00 Souvenir Shirt $ $ ITEM X 12.00 Each (Youth Small - Adult XL) X 15.00 Each (2XL-3XL) X COLOR SIZE QTY Regular T-Shirt 100% Cotton Antique Cherry Red * Youth Sizes Cherry Red QTY QTY YOUTH Small (6-8) * Adult Small Adult X-Large YOUTH Medium (10-12) * Adult Medium Adult XX-Large YOUTH Large (14-16) * Adult Large Adult XXX-Large TOTAL $ Non-Refundable Contestant Rules • The “One-Bite Wonder” can be any item of your choosing, other than the 4 Basic Categories • All meats or seafoods must be USDA stamped • No Wild Game • MUST BE PREPARED ON SITE, ON GRILL • It shall be composed so that it is totally edible, and able to be eaten in 1 or 2 bites... (Six individual portions must be prepared for judging) • Garnish is strictly forbidden • NO DESSERTS • It will be judged totally on its looks and taste • The format is that everyone throws entry fee in a pot, and we pay the Top 3 Places • This is NOT A KCBS category cash prizes 1st Place - 3rd Place Announced on Friday • October 10th, 2014 on the Square Release/Waiver of Liability: In consideration of your accepting this entry, I, the undersigned, intend to be legally bound hereby for myself, my heirs, executors and administrators, waive and release any and all rights and claims for the damage I may have against the Centralia Area Chamber of Commerce, the Centralia Park and Recreation, the City of Centralia and any other event sponsors, their agents, successors, sponsors, and assigns for any and all injuries suffered by myself, my team or my guests on this event. Further, I hereby grant full permission to the Centralia Area Chamber of Commerce to use any photographs, videotapes, motion pictures, recordings or any other record of this event for any legitimate purpose. _____________________________________________________________________ Signature of Chef _______________________________________ Date RGS Rev. 05-9-2014