California Purchase Release of Contingency

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Registered Racer’s Name:                                         (“RACER”)

          2010 SUZUKI CONTINGENCY REGISTRATION AND MINOR RELEASE – RIDERS UNDER 13

** For all Racers under the age of 13 years old, this document must be filled out in its entirety by the Racer and
Racer’s Guardian(s). No application for contingency submitted online for a Racer under the age of 13 will be
accepted. Should any Racer under the age of 13 years old submit an application for contingency online, Racer will
be disqualified from the contingency program for 2010.

RACER AND GUARDIAN(S) HEREBY AGREE THAT MOTORCYCLE RIDING AND RACING ARE
INHERENTLY DANGEROUS ACTIVITIES, AND RIDING MISHAPS AND/OR ACCIDENTS, IN COMPETITION,
TRAINING OR OTHERWISE, CAN RESULT IN SERIOUS INJURY OR DEATH. RACER AND GUARDIAN(S)
HEREBY EXPRESSLY ASSUME THE RESPONSIBILITY TO ASSESS SAFETY ASPECTS OF FACILITIES,
CONDITIONS, AND EQUIPMENT PRIOR TO EACH USE OF ANY AND ALL MOTORCYCLES AND PRODUCTS,
AND HEREBY EXPRESSLY ASSUME THE RISKS OF COMPETITION, TRAINING AND ANY OTHER SUCH USE.

RACER’S INITIALS: _______ GUARDIAN’S INITIALS ________                           ________
RIDER INFORMATION:


Address                                                           City



State                      ZIP                                    Phone (         )              -



DOB                /       /                              SSN              -      -


Personal E-Mail                                                   @                                      .

Choose Your Discipline(s):

___ Motocross              ___ National Road Race

                           ___ Regional Road Race


Bike/Model Information:



Suzuki Model Year              Suzuki Model Name                           Class Raced

VIN#

Date of Purchase       /           /               Dealer Purchased From




Suzuki Model Year              Suzuki Model Name                           Class Raced

VIN#

Date of Purchase       /           /               Dealer Purchased From
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Suzuki Model Year          Suzuki Model Name                               Class Raced

VIN#

Date of Purchase       /       /                  Dealer Purchased From

In consideration of being permitted to participate in the Suzuki Contingency Program during the 2010 season,
Guardian(s) and Racer, on behalf of Racer, Racer’s successors, heirs, assigns, minors, and incompetent persons (if
any), release and forever discharge American Suzuki Motor Corporation (“ASMC”), its parent company, and each of
their affiliates and related companies, agents, employees, servants, officers, directors, and authorized dealers
(collectively “Released Parties”) from all claims, actions, suits, or judgments I may have or claim to have against
ASMC and Released Parties, either now or in the future. Guardian(s) and Racer agree, on behalf of Racer, that
Racer is solely responsible for all personal injuries, including death, and damage to property, either real or personal,
caused by or arising out of or in any way relating to Racer’s participation in the Suzuki Motorcycle Contingency
Program for 2010, including any and all injuries, death, or property damage occurring either in whole or in part as a
result of ASMC and the Released Parties' active, gross, or other negligence (if any). Guardian(s) and Racer make
this release and discharge with full knowledge that motorcycle racing is a hazardous activity, and that it is impossible
to predict the existence or severity of any hazards or defects that may exist at the locations where the races will be
held.
Guardian(s) and Racer further agree on behalf of Racer, Racer’s successors, heirs, assigns, minors, and
incompetent persons (if any) to indemnify and hold ASMC and the Released Parties harmless from and against any
and all claims, actions, suits, or judgments for personal injuries, including death, and damage to property, either real
or personal, arising out of or in any way relating to Racer’s participation in the Suzuki Motorcycle Contingency
Program for 2010, and from and against any and all expenses (including costs and attorneys' fees) incurred in
defending said claims, actions, or suits, including any and all judgments or expenses occurring in whole or in part as
a result of the Released Parties' active, gross, or other negligence (if any).
Guardian(s) and Racer further agree that without any additional compensation, Racer’s name, photographs, pictures,
voice, likeness, slides, movies, or other reproductions, regardless of type or medium, taken of Racer or made in
connection with Racer’s participation in the Suzuki Motorcycle Contingency Program for 2010, and any copies of the
same, may in any manner or media be used by ASMC, or by any person, corporation, or association authorized by
ASMC.
Guardian(s) and Racer represent and warrant that Racer is in good health and has no physical conditions that would
prevent Racer from participating in motorcycle racing.
Guardian(s) and Racer expressly agree that Racer will fully abide with all the rules of the 2010 Suzuki Motorcycle
Contingency Program, which Guardian(s) and Racer have read at www.suzukicycles.com/racing.
Guardian(s) and Racer expressly understand and agree that Racer and/or Guardian(s) must own the motorcycle(s)
raced by Racer in the contingency races in order to receive payment. Guardian(s) and Racer agree to include proof
of ownership.* Guardian(s) and Racer agree, on behalf of Racer, to complete this application and submit it to ASMC
within 30 days after Racer’s first event in order to qualify for payment. Guardian(s) and Racer agree, on behalf of
Racer that applications submitted after the 30 day period will not be eligible for payment. Guardian(s) and racer
agree and acknowledge that it is Racer’s responsibility to resolve race result disputes with the race organization, and
that ASMC will only make payments based on results provided by the race organization.
Guardian(s) and Racer agree and acknowledge that professionals and amateurs will both receive a reloadable
Suzuki Rewards Card only redeemable at authorized U.S. Suzuki dealerships.
Guardian(s) and Racer, on behalf of Racer agree and acknowledge that section 1542 of the California Civil Code
states that a general release does not extend to claims which Racer does not know exist, or does not suspect exist at
the time of signing the release, and which, if Guardian(s) and/or Racer knew of or suspected such claims exist, would
have materially affected Guardian(s) and Racer’s willingness to sign the release. Notwithstanding the language of
section 1542, and with full knowledge and understanding thereof, by signing below, GUARGIAN(S) AND RACER,
ON BEHALF OF RACER HEREBY WAIVE RACER’S RIGHTS under section 1542 of the Civil Code of California
or any similar law of any other state, and Guardian(s) and Racer acknowledge that this waiver is an essential
term of this release without which ASMC and the Released Parties would not have allowed Racer to
participate in the Contingency Program.
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I understand that these program rules are subject to change without notice.
I HAVE READ AND UNDERSTAND THE FOREGOING RELEASE, AND AGREE TO ITS TERMS.
Racer's Name ________________________________ Date _________________________
Racer's Signature _____________________________________ Racer's SSN ____________________________

THE FOLLOWING SECTION MUST BE COMPLETED BY PARENT/GUARDIAN IF RIDER IS UNDER 18
I certify that I am the parent or guardian of the individual whose information appears on this form. I, ON BEHALF OF
MY MINOR CHILD, HAVE READ AND UNDERSTAND THE FOREGOING RELEASE, AND AGREE TO ITS
TERMS.

Name of Parent/Guardian ________________________________ Date _________________________
Parent/Guardian's Signature ________________________________________

Name of Parent/Guardian ________________________________ Date _________________________
Parent/Guardian's Signature ________________________________________

Address _________________________________________ City _____________________
State____ Zip ___________ Phone (___) _________________________

PLEASE MAIL COMPLETED FORM TO: ASMC MOTORCYCLE CONTINGENCY · 3251 E. Imperial Highway · Brea, CA 92821
OR FAX TO: (714) 579-1574 ATTN: ASMC MOTORCYCLE CONTINGENCY

				
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Description: California Purchase Release of Contingency document sample