Business Liability Wavier by ydz43907

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									                                                                                                         Event Date:


                                                                                       AMA #:                          Expires:


Name:                                                                           Address:

City:                                              State:                Zip:

Age:                          D.O.B.                        Phone#                         E-Mail

$20 Entry Fee                                 Trophy Classes
      Class               # Make           Class    # Make  Class                            # Make
     50cc 4-8                             50 Jr 4-6        50 Sr 7-8

$25 Entry Fee                                                Trophy Classes
      Class               # Make         Class               # Make   Class     # Make             Class                            # Make
    65 Jr 7-9                        Schoolboy 12-16                  125cc            Vintage 2002 older
   65 Sr 10-11                           Open B                        14-24              4-Wheel B
    85 Jr 9-11                           Open C                       +30 B               4-Wheel C
   85 Sr 12-15                            250 B                      Girls 8-15        90cc 4-Wheel 8-15
 Super Mini 12-16                        250 C                      Women 12-up        300 4-Wheel 13-15

$25 Entry Fee                                   Cash Payout Classes
     Class                # Make            Class     # Make Class  # Make                                               Class      # Make
     Open A                                  +30              +50                                             4-Wheel A
     250 A                                   +40              +55
      +25                                    +45

                THIS IS A RELEASE AND INDEMINTY AGREEMENT - READ IT BEFORE SIGNING
The UNDERSIGNED herby releases, waives, discharges and covenants not to sue the promoters,participants, racing associations, sanctioning
organization's, MUDDY WATERS inc. or any subdivision therof, track operators, track owners, officials, vehicle owners, drivers, pit crew, rescue
personnel, promoters, sponsors, advertisers, owners and leasees of premises used to conduct the EVENT (S) or daily business on premises and
inspectors, surveyors, underwriters, consultants and others who give recommendations, directions, or instructions or engage in risk evaluation
organization's, MUDDY WATERS inc. or any subdivision therof, track operators, track owners, officials, vehicle owners, drivers, pit crew, rescue
loss control activites regarding the premises or EVENT(S) or daily business and each of them, their directors, officers, agents, and employees, all
for the purpose herin referred to as "Releases", from all LIABILITYCLAIM OR DEMANDS THEREFOR ON ACCOUNT OF INJURY TO THE PERSON
OR PROPERTY OR RESULTING IN DEATH OF THE UNDERSIGNED ARISING OUT OF OR RELATED TO THE EVENT(S) OR DAILY BUSINESS,
WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR THERWISE. THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND
SAVE AND HOLD HARMLESS the Releasees and each of them from any loss, liability, damage or cost they may incur arising out of or related to the
EVENT(S) or daily business whether caused by the negligence of the Releaseesor otherwise. THE UNDERSIGNED hereby assumes full
responsibility for any risk of bodily injury, death or property damage arising out of or related to the EVENT(S) or daily business whether caused
by the NEGLIGENCE OF RELEASEES or otherwise. I have read this Release and Wavier of Liability, Assumption of Risk and Indemnity Agreement,
 fully understand its terms, understand that I HAVE GIVEN UP SUBSTANTIAL RIGHTS by signing it and have signed it freely and voluntarily with
out any inducement, assurance or guarantee being made to me and extend my signature to be complete and unconditional release of all liability
to the greatest extent allowed by law.
                  (If participant is under age 18, his Parent or Legal Guardian must sign this form.)
                        I FULLY UNDERSTSND THAT THERE IS NO RIDER MEDICAL INSURANCE PROVIDED.
                                 I UNDERSTAND MOTORCYCLE AND ATV RIDING IS DANGEROUS.
                                                                                                                         FOR OFFICE USE ONLY
YES, I HAVE READ THIS RELEASE
                                                                                                                                  Entry Fee:
THIS IS A RELEASE
Signature of Participant                                                                                                AMA Membership:
THIS IS A RELEASE                                                                                                    District Membership:
Signature of Parent
                                                                                                                                     TOTAL:
           Minor Release Form                           District                                                                Staff Initials:

								
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