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Racer Info
  *=Required Field

Pre-registration is now closed. 

Please call Becky at (817)243-9515 for further assistance

Event* 
Pre-Registration Closes: 11/23/2013
Class* 
First Name*      Last Name*
Home Street Address* 
City*  State/Prov*  Zip* 
Birthdate*  MM/DD/YYYY
Parent/Guardian  If the racer is a minor, please input the name of the parent/guardian
E-Mail Address* 
 Example: bob@aol.com
Important, you must provide a valid e-mail address so that
a confirmation for your entry can be e-mailed to you.
Phone Number*  xxx-xxx-xxxx
AMA Number*           Exp*
Sponsors  250 characters max
characters remaining
Select Billing Type
  

The UNDERSIGNED hereby releases, waives, discharges and covenants not to
sue the promoters, participants, racing associations, sanctioning
organizations or any subdivision thereof, track operators, track owners,
officials, vehicle 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, consultant and others who give
recommendations, directions, or instructions or engage in risk
evaluation or loss control activities regarding the premises or EVENT(S)
and each of them, their directors, officers, agents, and employees, all
for the purposes herein referred to as “releases,” 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 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), WHETHER
CAUSED BY THE NEGLIGENCE OF THE RELEASES OR OTHERWISE.
THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS
the Releases and each of them from any loss, liability, damage or cost
they may incur arising out of or related to the EVENT(S) whether caused
by the negligence or 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) 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 its terms, 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
it under age 21, this form must be signed by his Parent of Legal Guardian.)