DONUT EATING CONTEST DETAILS & RULES

Gerlach Girls Guardian Angels

Chomp-for-a-Cure Donut Eating Contest
All entry forms, release forms, and entry fees are due by
September 8
th
, 2014 to D-Lishas Bakery.

Contest Date: Saturday, September 20
th
, 2014
Location: D-Lishas Bakery, 1218 Swanwick Street, Chester, IL 62233
Time: Youth Competition 1:00pm, Adult Competition 1:30pm
Age Groups will be determined after all entry forms have been turned in so one contest is not weighted
over the other. Contestants must be at least 18 years of age or have a parent/guardians consent to
participate in this event. A release form must be signed by all participants. Youth participants will be
supplied with donut holes and have 3 minutes to consume as many as possible. Adult participants will
be supplied with glazed donuts and have 5 minutes to consume as many as possible.
All participants must be present by 12:30pm at the contest location to check-in on the day of competition
or you risk being disqualified from the event with no refund.
Entry Fee: A minimum donation of $25 or a pledged donation of at least $25 is due by the
entry deadline.
Participants can either pay the entry fee themselves or accumulate pledge donations for each donut
they consume the day of the event. A pledge donation form is attached to the back of this packet.
Pledged donations will be due by September 27
th
to D-Lishas Bakery. All checks can be made payable to
Emily Gerlach. (All donations will be given to the Cystic Fibrosis Foundation Gateway Chapter.)
Prizes: Awards for each age group as well as for most donations earned will be given out at
the event.
The overall winner of the event will also be presented a special coffee mug that will be kept at D-Lishas
Bakery on display and can be used by the winner for one free fill up per visit.

Rules:
All contestants must present entry fee and release form by due date to be eligible to participate
in the contest.
All pledged donations are due by September 27
th
. A failure to turn in pledged donations will
result in any awards being stripped from the participant and a ban from future participation in
any Gerlach Girls fundraising event.
Each participant will be presented with a platter of donut holes/donuts depending on their
category and have an allotted time to consume as many donuts/holes as possible. The person
who has consumed the most donuts/holes when time is called will be the winner for their
category.
Each participant will be allowed one small glass of water which will be supplied by those in
charge of organizing the competition.
No tools other than your hands may be used to aid in your consumption.
No other persons other than the single participant will be allowed to aid in the consumption of
said participants platter.
A whistle will signal the start and finish of each category.
Tearing, separating, smashing, and soaking of items in water will be permitted.
Judges have the right to disqualify any participant they feel is not abiding by the rules or is
deemed unfit for the competition.
All consumed donuts/holes by contestants will have to be kept down for at least 5 minutes upon
conclusion of said contestants contest in order for them to be named a winner. Upchucking of
consumed donuts/holes will result in a disqualification from the event.

CONTESTANT ENTRY & RELEASE FORM
Gerlach Girls Guardian Angels
Chomp-for-a-Cure Donut Eating Contest

Name: _______________________________________________________ Date: _______________
Address: __________________________________________________________________________
Phone Number: _______________________________________________ Age: _________________
Emergency Contact Number:_____________________________________Relationship:___________
Do you have any serious medical condition or injury that may be affected by this contest?
Please circle YES or NO If yes, please explain in detail:____________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Do you have any allergies?
Please circle YES or NO If yes, please explain in detail:____________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Do you understand that we may use a photograph or videotape of you during this contest recognizing it
will be used for promotional purposes and posted on social media, local print media, or the internet?
Please circle YES


WAIVER OF LIABILITY

It is expressly understood by the participant, the undersigned herein, (participant and parent/guardian if
under 18 years of age) that entry and participation in the Contest and all related events and activities,
including travel and time spent at D-Lishas Bakery, in Chester, Illinois and in the surrounding area, shall
occur at the undersigneds own risk.
The participant stipulates that he or she is 18 years of age or older, or if under 18 years of age
has parents consent below, and is in good health and agrees to abide by all contest rules, to
compete in a safe and reasonable manner, and to accept all judges rulings.
The undersigned understands they will be engaging in activities that involve risk of damage to
personal property or serious injury, including choking, vomiting, or feeling nauseous or dizzy, and
social and economic losses which might result not only from their own actions, inactions or
negligence, but also the actions, inactions, or negligence of others, the rules of play, the condition
of the premises or of any equipment used or food consumed. Further, there may be other risks
not known or not reasonably foreseeable at this time.
The undersigned understands the health and associated risks inherent in eating contests and in
the consumption of large quantities of food and calories. The undersigned agrees that the
participant, and parent/guardian if under 18 years of age, assumes all liability for such risks.
The undersigned fully, finally and unconditionally releases and discharges D-Lishas Bakery, the
Gerlach Girls Guardian Angels, Great Strides, the Cystic Fibrosis Foundation and its affiliated
companies and Franchisees, organizers of the eating contest, the venue hosting the contest, and
their respective owners, directors, officers, agents, attorneys, employees, fiduciaries, parents,
subsidiaries, divisions, partners, sponsors, joint ventures, affiliated business entities,
predecessors, successors, heirs and assigns, jointly and severally, from any and all claims,
liabilities, suits, discrimination or other charges, demands, debts, liens, damages, costs,
attorneys fees, prejudgment or other interest, grievances, injuries, actions or right of action of any
nature whatsoever now or in the future.
The participant agrees to speak with media and authorized interviewers regarding the event and
agrees to release all rights on their image, performance and interviews before, during or after the
event for use or sale by media, interviewers and organizers.
The undersigned releases all temporary and full-time employees and agents of D-Lishas Bakery
and its Franchisees, from all claims regarding the outcome of interviews and for the manner in
which they are portrayed by media or other individuals or organizations involved in the contest
and related events.
The undersigned further agrees that this waiver is to the undersigneds full and complete
satisfaction and understanding, that the participant has been given a copy of this Waiver if
requested, and that the undersigned agrees to and with all of the aforementioned items.
FINAL AUTHORITY: D-Lishas Bakery in conjunction with the Gerlach Girls Guardian Angels has
sole and complete discretion regarding all contest related matters. All decisions regarding
qualifications, selection or disqualification of a contestant/s or winner/s shall be subject to the
sole and complete discretion of D-Lishas Bakery or the Gerlach Girls Guardian Angels. You can
be disqualified for any reason at any time.
CERTIFICATION AND SIGNATURE: I certify that the information provided is correct and that I
have carefully read, understand and accept the terms of the Gerlach Girls Guardian Angels
Chomp-for-a-Cure Donut Eating Contest Rules and Entry Form. My signature indicates my
understanding and assumption of the risks and my voluntary participation in this contest.

Name: _______________________________________________________ Date: _______________
Signature: _________________________________________________________________________
Address: __________________________________________________________________________
Phone Number: _______________________________________________ Age: _________________
If Participant is under 18 years of age, a parent/guardian must be present and give consent below:
I, __________________________________, am a parent/guardian of __________________________,
named above. I give my consent to participation by this Minor child in the above-described contest.
Name:______________________________________________________ Date:__________________
Address (if different from participant)_____________________________________________________
Phone Number: _________________________________

PLEASE RETURN:
Entry Form, Signed Waiver of Liability, Entry Fee/Copy of Pledge Form to
D-Lishas Bakery at 1218 Swanwick Street in Chester, IL by September 8
th
, 2014

Chomp-for-a-Cure
A Gerlach Girls Guardian Angels Cystic Fibrosis Foundation Fundraising
Donut Eating Contest | September 20
th
, 2014 at 1:00pm
D-Lishas Bakery 1218 Swanwick Street, Chester, IL
PLEDGE DONATIONS

All pledged donations are due by September 27
th
upon conclusion of the contest event.
By making a pledge donation below, you are consenting to donate the amount you have
indicated in the Pledge Amount column per donut consumed by the contestant listed at the top
of this form. Your contestant will be given 3min. to consume as many donut holes as possible if
they are a youth participant or 5min. to consume as many glazed donuts as possible if they are
an adult participant. All donations will go to the Cystic Fibrosis Foundation.

Contestant Name:____________________________________________________________
Will be participating in the YOUTH | ADULT contest. (To be circled by those running competition.)

(To be filled in by those running the competition.)


You consumed _______ donuts on September 20
th
, 2014
as part of the above competition.
Please multiply the number of donuts consumed by the pledge amount per person to determine each persons total
due. Collect donations and return to D-Lishas Bakery by September 27
th
, 2014. Checks can be made payable to
Emily Gerlach. If a receipt of payment is needed please contact the Gerlach Girls Guardian Angels at
[email protected]



Printed Name Signature of Consent Pledge Amount
(per donut)
Total Due























Total Amount Pledged Per Donut $__________
X # of Donuts Consumed __________
= $___________
Total Amount Collected



PLEASE TURN IN PLEDGE FROM WITH ENTRY FORM AND SIGNED WAIVER