SoyFoam Farm to Fire Nebraska Event Registration - SoyBiobased.org : SoyBiobased.org

Join us at the Kearney Fire Department in Kearney, Nebraska to see SoyFoam™ TF 1122 in action. As the first and only firefighting foam to earn GreenScreen Certified® Gold, SoyFoam™ TF 1122 represents a breakthrough in PFAS- and fluorine-free firefighting.

Witness its performance across a range of live demonstrations and testing environments. Engage directly with firefighters, scientists, evaluators, and the manufacturer—alongside the farmers helping to bring this innovation to communities across the country.

Event Details
When: Wednesday, June 24, 10:00 a.m. to 1:00 p.m. CT
Where: Kearney Volunteer Fire Department (KVFD) Training Complex
4300 Piper Avenue, Kearney, NE 68847

This field is for validation purposes and should be left unchanged.

Personal Information

Name

First Last

Job Title

Organization

Address

Street Address Address Line 2 City State ZIP Code

Phone

Emergency Contact

In case of an emergency, contact the following person(s):

Name

First Last

Relationship to you

(parent, uncle, friend, etc.)

Address

Street Address Address Line 2 City State ZIP Code

Phone

Accessibility Needs

Special Accommodations

Auditory

Mobility

Visual

Special Accommodations Details

Acknowledgement of Risks, Acceptance of Responsibility, Release of Liability and Hold Harmless Agreement

Please read and initial each section.

Please Read and Initial Below

I fully understand and voluntarily assume any and all risks and responsibilities associated with my participation in activities involving the Nebraska Soybean Board, Cross Plains Solutions, the United Soybean Board, and the Kearney Fire Department, including the SoyFoam™ Farm to Fire Nebraska event, SoyFoam™ TF 1122 demonstrations, and related activities hosted at the Kearney Fire Station in Kearney, Nebraska. I acknowledge that participation in this activity may be inherently hazardous and could result in injury, including but not limited to burns, inhalation of smoke or other chemicals, bodily injury, strain, sprain, or other serious injury. In recognition of these inherent risks, I confirm that I am physically and mentally capable of participating in this activity. I choose to participate willingly and voluntarily and accept full and complete responsibility for any personal injury, loss, or damage that may occur as a result of any accident or incident arising from my participation.

Please Read and Initial Below

I specifically understand that I, my personal representatives, and my heirs are releasing, discharging, and waiving any and all claims, actions, or losses for bodily injury, property damage, loss of services, or otherwise, whether known or unknown, present or future, arising out of or related to any negligent acts or other conduct by the United Soybean Board, the Nebraska Soybean Board, Cross Plains Solutions, or the Kearney Fire Department, including their officers, directors, employees, agents, contractors, representatives, or other affiliated parties.

Please Read and Initial Below

In signing this Waiver and Agreement, I acknowledge and represent that I have fully informed myself of the content of the foregoing Acknowledgement of Risks and Acceptance of Responsibility by reading it before I sign it; and I understand that I sign this document as my own free act and deed with no oral representations, statements, or inducements, apart from the foregoing written statement, having been made. I understand that the United Soybean Board, the Nebraska Soybean Board, Cross Plains Solutions, and the Kearney Fire Department do not require me to participate in this activity, and that my participation is entirely voluntary. Nevertheless, I choose to participate despite the possible dangers and risks and despite this Waiver and Agreement. I further state that I am at least eighteen (18) years of age and fully competent to sign this Waiver and Agreement; and that I execute this Waiver and Agreement for full, adequate, and complete consideration fully intending to be bound by the same. I further state that there are no health-related reasons or problems which preclude or restrict my participation in this activity, and that I have adequate health insurance necessary to provide for and pay any medical costs that may be incurred as a result of injury to me.

Media/Photo Release

Please Read and Sign Below

I allow the United Soybean Board and others working for or with the United Soybean Board, including the Nebraska Soybean Board, Cross Plains Solutions, and the Kearney Fire Department, the unlimited right and permission to use my name, picture, likeness, voice, and biographical information, together with any other material the United Soybean Board so chooses, in any manner, venue, or media, anywhere in the world, at any time for the purposes of advertising, promoting, and publicizing the United Soybean Board, the Nebraska Soybean Board, Cross Plains Solutions, SoyFoam™ TF 1122, and related activities. I agree that I have no right of approval over any materials, no claim to compensation, and no claim arising out of any use of my name, picture, likeness, voice, or biographical information. I will not disclose any confidential information, including the content of any advertising material that is not yet public, to any person or entity without the United Soybean Board’s prior written approval. I agree that this agreement will be governed by the laws of the State of Nebraska without regard to its choice of law provisions.