Rider Bike number and brand information will be submitted on the next page.
**NOTE:** If you wish to pay with a credit or debit card, please select the PayPal option. It will take you to a payment screen that will allow you to select your form of payment. Please call 801-540-8625 if you have any questions.
The UNDERSIGNED hereby releases, waives, discharges and covenants not to sue Rocky Mountain Motocross Series, Grassroots MX, 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 18, this form must be signed by his Parent of Legal Guardian.)