Full Throttle MX Series
Round 3
Saturday July 10th
On Line Registration for Saturday, July 10, 2010
Last Name*:First Name*
Address*:City*:State*Zip*:
Birth date*: If minor, Parents name:phone*:
Email address*:
BIKE INFORMATION:
CLASS 1
SELECT A CLASS 50cc Jr. (4-6) 50cc Sr. (7-8) 50cc Open (4-8) 65cc Jr. (7-9) 65cc Sr. (10-11) 65cc Open 85cc Jr. (7-11) 85cc Sr. (12-15) 85cc Open SchoolBoy (12-16) Open CollegeBoy (17-24) Open 125cc Beg. 125cc Advanced 250cc Beg. 250cc Advanced Over 25 Over 35 Over 40 Combined Pro
TO RACE THE BIKE/RIDER ENTERED ABOVE IN ADDITIONAL CLASSES:
Class 2 - select class
Class 3 - select class
Class 4 - Select Class
To register the same rider on a second bike, please complete this section:
BIKE #2 INFORMATION:
SIZECC
BRAND
NUMBER
Class 1
TO RACE THE BIKE ENTERED ABOVE IN ADDITIONAL CLASSES
Class 4 - select class
Sponsors:
I, the undersigned do hereby agree to hold harmless the owner, management and track employees of TMX Park for any and all liability, injury or damage caused by or in any way arising out of or in connection with the facilities and services of TMX Park.
Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement
The UNDERSIGNED hereby releases, waives, discharges and covenants not to sue the promoters, participants, racing associations, sanctioning organizations or any subdivision there of, track operators, track owners, drivers, pit crews, rescue personnel, any persons in any RESTRICTED AREA. Promoters, sponsors advertisers, owners and lessees of premises used to conduct the EVENT (S), premises and event inspectors, surveyors, underwriters, consultants and others who give recommendations, directions, or instructions or engage n risk evaluation or loss control activities regarding the premises or EVENT S) and each of them, their directions officers, agents, and employees, all for the purposes herein referred to as “Releasees” from all LIABILITY TO THE UNDERSIGNED, his personal representatives, assigns, heirs, and next of kin FOR ANY AND ALL LOSS OR DAMAGE AND ANY CLAIM OR DEMANDS THEREFORE 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) WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASES OR OTHERWISE, THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND SANE AND HOLD HARMLESS the Releases and each of them from loss, liability, damage, or cost they may incur arising out of or related to the EVENT (S) whether caused by the NEGLIGENCE OF RELEASES or otherwise.
I have read this Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement, fully understand that I have given up substantial rights by signing it and have signed it freely and voluntarily without any inducement, assurance, or guarantee being made to me and extend my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law. (If participant is under age 18, this form must by signed by his Parent or Legal Guardian)
I FULLY UNDERSTAND THAT THERE IS NO RIDER MEDICAL INSURANCE PROVIDED
I UNDERSTAND MOTORCYCLE RACING IS DANGEROUS
YES, I HAVE READ THIS RELEASE
Rider's signature*: date*:
Parent's signature*: date*:
The signature (s) above are legal and binding signatures as governed by Texas Law..
Texas Electronic Signature Law
Entry Fee Calculation Select Total Number of Classes Entered 0 1 2 3 4 5 6 7 8
After Completing The Entry Form Click the "Submit" Button Below A Preview Page Will Give you the chance to review the information that you have sent.
To Clear all Information :