DAT MX Events Online Signup

Online Signup
for Round 4 of the 2010 "West" Sunbelt Series
and the Spring Valley 2010 Opener
by DAT MX Events and Maxs Kawasaki Yamaha Honda Polaris in Abilene

Last Name     First Name

First Class     Second Class Third Class

Bike Number      Bike Brand         Bike Size

Date of Birth (eg) __/__/__     Age

Address    City      State     Zip

email     Best Contact Phone #

SPONSORS (Top 3 ONLY Please)

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT I HEREBY RELEASE, DISCHAGRE AND COVENANT NOT TO SUE the promoter, participants, racing associations, sanctioning originations or any subdivision thereof, track operators, track owners, officials, car 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 or event inspectors, surveyors, underwriters, consultants and other persons or entities 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 purpose herein referred to as “Release”, FROM ALL LIABILITY TO ME, THE MINOR, my and minors personal representatives, assigns, heirs, and next of kin, FOR ANY AND ALL CLAMIS, DEMANDS, LOSSES, OR DAMAGES ON ACCOUNT OF ANY INJURY, 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. 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 make 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 IS UNDER AGE 18, SEE FORM LINK BELOW AS IT MUST BE SIGNED BY PARENT OR LEGAL GAURDIAN)

After reading the above Release and Waiver of Liability, please type in YES to agree

I FULLY UNDERSTAND THAT THERE IS NO RIDER MEDICAL INSURANCE PROVIDED
I UNDERSTAND MOTORCYCLE RACING IS DANGEROUS
YES, I HAVE READ THE RELEASE AND WAIVER ABOVE AND AM OVER 18 YEARS OLD

DIGITAL SIGNATURE of RIDER (If under 18, see below)

The Electronic Signatures in Global and National Commerce Act
(ESIGN, Pub.L. 106-229, enacted June 30, 2000 is a United States federal law
passed by the U.S. Congress to facilitate the use of electronic records and signatures
in interstate and foreign commerce by ensuring the validity and legal effect
of contracts entered into electronically.

BELOW IS FOR PARENTS FOR UNDER 18 PARTICIPANTS

CLICK HERE FOR PARENTAL CONSENT
After reading the Parental Consent, please type in YES to agree

DIGITAL SIGNATURE of PARENT or LEGAL GUARDIAN of RIDER (if under 18)

The Electronic Signatures in Global and National Commerce Act
(ESIGN, Pub.L. 106-229, enacted June 30, 2000 is a United States federal law
passed by the U.S. Congress to facilitate the use of electronic records and signatures
in interstate and foreign commerce by ensuring the validity and legal effect
of contracts entered into electronically.