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Pop the Balloon Pittsburgh Contestant Registration Form

Birthday
Month
Day
Year

Demographics

Gender
Sexual Orientation
Which age group do you belong to?
What type of partner are you looking for?

Participation Questions

Consent and Agreements

Media Release Agreement

By signing this form, I grant permission to Daressia Industries LLC to use my name, image, voice, and likeness in any recordings, photographs, or promotional materials related to Pop the Balloon Live. I understand these materials may be used for marketing, social media, and broadcasting purposes without compensation.

Liability Waiver

I understand that participation in Pop the Balloon Pittsburgh Live is voluntary and that I assume all risks associated with the event, including interactions with other contestants. I release Daressia Industries LLC, the host venue, volunteers, and staff from any liability for injuries, death, illnesses, disputes, or damages that may arise before, during, or after the event.

Code of Conduct

I agree to conduct myself professionally and respectfully toward all contestants, audience members, and event staff. I understand that any inappropriate behavior may result in my removal from the event.

Acknowledgment & Signature

By signing below, I confirm that all information provided is accurate, that I have read and understood the terms of participation, and that I voluntarily agree to these conditions.

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Thanks for registering to our event. See you there!

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