ATV/MC ____________ Class ______________________ Bike # _____________

Name_________________________ Date of Birth ________________ Age _______________

Address ________________________________________________________________________

Email address ______________________________Phone Number__________________________

THIS IS A REALEASE INDEMNITY AGREEMENT-READ IT BEFORE SIGNING

I hereby give up all my rights to sue or make any claim for damages due to negligence or any other reason whatsoever against the Good Evening Raceway and their respective district organizations, promoters, sponsors and all other persons, participants or organizations conducting or connected with this event for injury to property or person I may suffer, including crippling injury or death, while participating in the events and while on event premises. I know the risk of danger to myself and my property while preparing for and participating in the event and while upon the event premise, and relying upon my own judgement and ability, assume all such risks of loss and hereby agree to reimburse all costs to those persons or organizations connected with this event for damages incurred as a result of my negligence.

THIS IS A REALEASE______________________ THIS IS A REALEASE _______________________

Signature of Participant Signature of Minor’s Parent/Guardian