BE SURE TO FILL out the above form AND to read and sign the Disclaimer and Release at the bottom of this page. We need to have these TWO forms in our file before we can send you all your registration materials. Mail these forms to us.
Phone: Cell 352-684-5293 | E-Mail: rally@rideRT66.com
PLEASE SIGN AND RETURN to Ride RT 66 LLC 12415 Linden Drive spring Hill Florida 34608
RELEASE AND INDEMNITY AGREEMENT PLEASE READ IT BEFORE SIGNING BELOW
I hereby give up all my rights to sue or make any claim whatsoever against the officers, employers or agents of Ride RT 66, LLC of Spring Hill Florida, sponsors and all other persons, participants or organizations conducting or connected with the event* for any injury to property or person I may suffer, including but not limited to crippling injury or death, whether such injury arises while I an preparing for or participating in the event or while I am upon the event premises.
I know the Risks of danger to myself and my property while participating in the event and while upon the event premises and relying upon my own judgment 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.
My Car or motorcycle meets all noise, insurance and registration requirements for the State in which it is licensed.
Operator Signature__________________________________________________________________________________
Print Name____________________________________________________________________Date____________
Passenger Signature______________________________________________________________________________
Print name_____________________________________________________________________Date_____________
Relationship to rider (Spouse,Relative, Friend)______________________________________.
*The Annual Mother Road Rally
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