print form - fill out and bring along with you to expedite sign-in
 

 

 

 

Minor's Name (Last, First, Middle)

 

 

 

Minor's Date of Birth
 
Parental Consent, Release and Waiver of Liability,
Assumption of Risk and Indemnity Agreement
 
Annual Minor Release Form
 

 

 

 

Event Location and Description
 
In consideration of my minor child ("the Minor") being permitted to participate in any way in the Event(s) and/or being permitted to enter for any purpose and Restricted Area(s) (defined to be any area which requires special authorization, credentials or permission to enter of any area to which permission by the general public is restricted or prohibited), I agree:
1. I know the nature of the Event(s) and Minor's experience and capabilities, and believe the Minor to by qualified to particiapte in the Event(s). I will inspect the premises, facilities and the equipment to be used, or with which the Minor may come in contact. If I, or the minor, believe anything is unsafe, I will instruct the minor to immediately leave the restricted area and refuse to participate further in the event(s).
2. I fully understand and will instruct the Minor that: (a) the activities of the event(s) are very dangerous and participation in the Event(s) and/or entry into Restricted Areas involves risks and dangers of serious bodily injury, including permanent disability, paralysis and death ("Risks"); (b) these Risks and dangers may be caused by the condition and layout of the premises and equipemnt, or the negligence of the Releasees named below; (c) there may be other risks not known to me or that are not readily foreseeable at this time; (d) the social and economic losses and/or damages that could result from these Risk(s) could be severe and could permanently change the Minor's future.
3. I consent to the Minor's participation in the Event(s) and/or entry into the restricted areas and hereby accept and assume all such risks, known and unknown, and assume all responsibility for the lossed, costs and/or damages following such injury, disability, paralysis, or death, even if caused, in whole or in part by the negligence of the Releasees named below.
4. I hereby release, discharge and covenant not to sue the promoters, participants, racing associations, sanctioning organizations, or any subdivision thereof, track operators, track owners, officials, car owners, drivers, pit crews, rescue personnel, any persons in a restricted area, promotors, sponsors, advertisers, owners, and lessees of premises used to conduct the Event(s), premises and event inspectors, surveyors, underwriters, consultants and other persons or entities or Event(s) and each of them, their directors, officers, agents and employees, all for the purposes herein referred to as "Releasees", from all liability to me, the Minor, my personal representatives, and the Minor's personal representatives, assigns, heirs, and next of kin for any and all claims, demands, or damages on account of any injury to me or the Minor, including, but not limited to, death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the Releasees or otherwise.
5. If, despite this release, I, I Minor, or anyone on the Minor's behalf, makes a claim against any of the Releasees named above, I agree to indemnify, and save and hold harmless, the Releasees and each of the from any litigation expenses, attorney fees, loss, liability, damage, or cost they may occur due to the claim made against any of the Releasees named above, whether the claim is based on the negligence of the Releasees named or otherwise.
6. I sign this agreement on my own behalf, and on behalf of the Minor.
 
I have read this parental consent, release and waiver of liability, assumption of risk and indemnity agreement, fully understand its terms, understand that by signing this agreement I give up substantial right I and/or the Minor would otherwise have to recover damages for losses occasioned by the Releasees' fault, and sign it voluntarily and without inducement.
 

 

 

______________________________

 ______________________________ ______________________________
Signature of Male Parent or Guardian Printed Name of Male Parent or Guardian Relationship to Minor

 

 

______________________________

 ______________________________

 

______________________________
Signature of Female Parent or Guardian Printed Name of Female Parent or Guardian Relationship to Minor

 

 

______________________________

 ______________________________ ______________________________
Signature of Witness Printed Name of Witness Date
 
 
Minor's Assumption of Risk Acknowledgement
 

 

 

Description and Location of Scheduled Event(s)

 

 

Date Release was signed
 
I have obtained my parent's consent to particiapte in the above Event(s). I understand that I am assuming all the risks if I get hurt during the event(s), and I state the following:
1. Both of my parents and I believe I am qualified to participate in the Event(s). I will inspect the premises and equipment and if, at any time, I feel anything to be unsafe, will immediately leave and refuse to participate further in the Event(s).
2. I understand that the activities of the event are very dangerous and involve risks and dangers of my being seriously hurt or injured my being paralyzed or killed.
3. I know that these risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Event(s), the rules of the Event(s), the condition or layout of the premises and equipment, or the negligence of others, including those persons responsible for conducting the Event(s).
I have read the above assumption of risk acknowledgement, understand what I have read, and sign it voluntarily.
 

 

 

____________________________________

 

 

____________________________________
Signature of Minor Participant Date

 

 

____________________________________

 

 

____________________________________
Printed Name of Minor Participant Age

 

 

____________________________________

 

____________________________________
Signature of Witness Printed Name of Witness