Proceeds Benefit St Jude Children's Research Hospital
Quantity of Patches, Pins and T-Shirts Available on site will
Click HERE to see Shirt Color & Size Info
T-Shirts ( Specify Size & Color of each size needed )
How Many below "*" should match TShirt/Tank Top "*" sections above
|How many T-Shirts ?
||Size & Color 1st Shirt
||Size & Color 2nd Shirt
||Size & Color 3rd Shirt
||Size & Color 4th Shirt
|How many Ladies TankTops ?
||Size & Color 1st TankTop
||Size & Color 2nd TankTop
||Size & Color 3rd TankTop
||Size & Color 4th TankTop
RELEASE AND WAIVER OF LIABILITY
AND INDEMNITY AGREEMENT
To participate in 2013 Georgia State SCRC Rally,
you are required to fully read and sign the following
waiver of liability.
Date: 01 February 2013
RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT IN CONSIDERATION for being permitted to participate in the 2013 Georgia State SCRC Rally, benefitting St. Judes Childrens Hospital sponsored by the Southern Cruisers Riding Club at the Howard Johnson's in Commerce, GA the weekend of July 19th - July 22nd, 2013.
THE UNDERSIGNED PARTICIPANTS:
1. HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE The Southern Cruisers Riding Club, owners and lessees of premises used to conduct the event and each of them, their officers and employees, The State of Georgia, the dealers, officers, directors, management, officials and volunteers assisting in the event, the sanctioning organization or any subdivision thereof, grounds operators, grounds owner, officials, promoters, sponsors, advertisers; all for the purpose herein referred to as releasees, from all liability to the undersigned, their 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, whether caused by the negligence of the releasees or otherwise while the undersigned is participating in the event;
2. HEREBY AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS the releasees and each of them from any loss, liability, damage, or cost (including attorneys fees) they may incur due to the presence of the undersigned participating in the event and whether caused by the negligence of the releasees or otherwise.
3. THE UNDERSIGNED PARTICIPANTS agree that while participating in this event, the use of alcohol or any substance which affects the ability to operate or control his or her vehicle or may be considered as hazardous to the health and safety of participants and spectators is strictly forbidden.
4. THE UNDERSIGNED AGREES that he or she will not use or operate any vehicle in violation or contravention of any City, County, State or Federal laws, statures, ordinances or regulation and shall be personally liable for all fines and penalties for traffic law violations.
5. HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE due to the negligence of releasees or otherwise while participating in the event. EACH OF THE UNDERSIGNED expressly acknowledges and agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by law of the State in which it is operated in and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. By my electronic signature hereto, I acknowledge that I have read the above RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT and that I concur in its entirety, and further agree that no oral representations, statements or inducements apart from the foregoing written agreement have been made.
Rider's Acknowledgement *
Passenger's Acknowledgement *
Prior to pushing the "Submit Registration" button
You must type your name in the box above, exactly as it appears
on your photo ID, as your electronic signature to the Release and Waiver
of Liability and Indemnity Agreement.
I will make my payment by :
mailing my Check or
Online with Credit Card or Paypal
The submit registration button
below will submit your registration information and
forward you to the
Confirmation page where you can pay online now by Credit Card or Paypal.
You'll also find instructions there for mailing your payment by check.
You'll need to enter your Total $ from above as the 'donation' amount in the new window.
Did you verify Quantity, Size, and Color for the shirts ?
To print your registration before you submit it, click the PRINT button below :
( Don't forget to click the 'Submit Registration' too !)