35th Annual Washington Oldtimers Race Entry Form
Extreme Motorsports Park 12402 W Sprague Ave Airway Heights, WA. May 23-24, 2009 www.extmotorsports.com Thursday practice 10am-dark $20 Sign up & check in: 4-7pm Friday and 6-9am Saturday Friday practice 10am-3pm $20 Name______________________________________________________________________________________ Address_______________________________________________Phone________________________________ City___________________________________________State______________Zip_______________________ Chapter_____________________________________Date of Birth___________________Age______________
M/D/Year
Bike Number______Bike Brand_____________Email_________________________________T-shirt size_____
Please mark your class below with an x in the box. (M, L, XL, XXL, XXXL)
40+ Novice 50+ 50+ Novice 60+ Novice 70+ Novice 30+ A Support A
40+Amateur 50+ Amateur 60+ Amateur 70+ Amateur 30+ B Support B
40+ Expert 50+ Expert 60+ Expert 70+ Expert 30+ C Support C
40+ Master 50+ Master 60+ Master 80+ Master Women s (to be run w/ mini race) Mini - 85cc Mini - 65cc Pre Entry Deadline: May 12, 2009 Mail Entry To: WOTMX 30025 NE 172nd St Duvall, WA. 98019 No refunds after Saturday s practice.
PRE-ENTRY includes a FREE event t-shirt & one dinner ticket. 80+ Free 70+, Sup, Women & 65cc, 85cc $75 60+, 50+, 40+, 30+ $85 Gate entry per person $10 Gate entry per car load $40 RV Hook Up $15 per night Extra Dinner Tickets $8 per ticket
Assumption of Risk Agreement
I hereby acknowledge that I am aware of the dangers incident to this event and knowingly enter the event with said knowledge. I further acknowledge the risk of injury to myself or property while participating in or watching motorcycle events and I am aware that injuries sustained by me could be of permanent or grave nature and I, nevertheless, voluntarily and knowing will enter said events. I further acknowledge that during the course of said event there may be times at which through not actively participating in said event, I may be a spectator and that I may sustain permanent or grave injuries as a spectator and I nevertheless, voluntarily assume such risk. I further acknowledge that I may sustain permanent or grave injuries as either a participant or spectator at this event due to the negligence of other persons including participants, Extreme Motocross Park and it s workers, The Washington Oldtimers and it s members or other spectators and with that in mind, I, nevertheless voluntarily and knowingly assume such risk. I further agree that I will not sue or make any legal claims against any other participants, spectators, Extreme Motocross Park and it s workers, The Washington Oldtimers and it s members or other spectators whatsoever, no matter what injuries I may sustain as either a participant or spectator.
I HAVE READ THE ASSUMPTION AGREEMENT AND AGREE TO THE ABOVE CONDITIONS.
Rider Sign_______________________________________Date____________________ Parent Sign______________________________________Date_____________________
*****(I have read the assumption agreement above and agree to the above conditions for my child who is under 18 years of age.)******