2013 Coop Loop Application

Coop Application Deadline: Friday, February 22, 2013
Tour de Cluck Bicycle Coop Crawl: Saturday, May 25, 2013 ~ 9 am until 3 pm

Special Note: Your completed and submitted Coop Application implies your commitment to create a welcoming and satisfying experience for your coop visitors should your coop be selected for 2012. It also represents your agreement to be present and prepared to provide information and answer questions at your coop during the designated coop visitation hours. We hope you are excited about this unique opportunity to show off your coop and share your enthusiasm for chicken-keeping!

First Name:	Last Name:
My Address:
Coop Address:	Coop address same as my address
Phone:	Email:

Location: Central Davis North Davis East Davis Mace Ranch Wild Horse West Davis South Davis Willowbank El Macero Rural/Other

Coop Style: Rustic Recycled Creative/Unique Conventional Achitectural Gem Chicken Tractor Other (describe below)

Coop Size: Small 4'x6' or less Med 4'x6' - 8'x10' Large 8'x10 or more'

Best Time for Site Visit:
Sat. 2/23 9:00 AM to 12:00 PM Sat. 2/23 1:00 PM to 4:00 PM	Sun. 2/24 1:00 PM to 4:00 PM	Sat. 3/2 9:00 AM to 12:00 PM Sat. 3/2 1:00 PM to 4:00 PM



1. Because you will experience increased traffic on your street during the Coop Crawl,
   we must ask. Do your neighbors approve of your chickens and will they approve of your participation?
   Yes No
2. Will there be ample space for car and bicycle parking for a large number of visitors?
   Yes No
3. Each coop selected requires a total of 4 people to act as docents. That number includes you the coop owner(s), as well as any family members, friends and neighbors you recruit to assist visitors during the hours of the Tour. As coop owner, you must arrange for your coop docent team. It’s fun! Be prepared to provide your 4 docent names should your coop be selected for a site visit. Can you commit to providing this necessary coop support?
   Yes No
4. At the time of the Tour de Cluck, how many chickens will you have in your coop?
   
5. What breeds will you have? Please indicate the number and ages of each:
   
6. What else should we know about your chickens or coop?:
   
7. Questions/Comments?
   

I acknowledge that this waiver and release of liability form will be used by the event holders, sponsors, and organizers of the Tour de Cluck: A Bicycle Chicken Coop Crawl, and that it will govern my actions and responsibilities at this event. I hereby take action for myself, my executors, administrators, heirs, next of kin, and successors. I hereby Waive, Release and Discharge from any claims, losses, or liabilities for death, disability, personal injury, property damage, theft or damage of any kind resulting from my participation in this event. I also grant permission to use photos or video of myself and/or my chicken coop submitted to Tour de Cluck or taken in conjunction with this event, in any broadcast or telecast. In addition, I grant permission to post said photos or video on the websites of or in print material produced by the event holders, sponsors, and organizers of the Tour de Cluck. I hereby certify that I have read this document and completely understand its contents.
If the coop applicant is under 18 years of age, a parent or guardian must complete the application and agree to the terms of this waiver.
I Agree:

Include a photo of your coop with your application here (Max size 2MB):