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The form below is a picture in JPG format. It will not correctly print straight from this web page. You'll need to save it to a disc or on your computer to get it to properly print. Then use the appropriate program to print it out on 8.5"x11" paper so that it is complete and legible, fill it out, and send it in to the address below.
Just in case you want to read it first, it is copied below...
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WIND & FIRE MC
“SOUTHERN RALLY – 2008”
RELEASE AND REGISTRATION
I, the undersigned Participant, and on behalf of myself and my heirs, personal representatives, successors and assigns, for and in consideration of the opportunity to participate in the Wind & Fire MC Southern Rally – 2008 sponsored by WIND & FIRE MC, Inc., and its local Wind & Fire Motorcycle Club Chapter(s) (the “Rally”), scheduled to occur on Friday, June 13, 2008 from 3:00pm to 6:00pm, and on Saturday, June 14, 2008 from 08:00am to 5:00pm, and on the dates of June 12, 2008 to June 15, 2008 as more fully described on the Wind & Fire MC Southern Rally website located at “www.wfmcsouthernrally.net“, and for other good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, releases and holds WIND & FIRE MC, Inc., and its local chapters, their respective officers, volunteers, employees, assigns, successors, and agents (the “Released Parties”) harmless from any and all losses, property damage, personal injury, and any other claim, demand, right, or cause of action of any kind whatsoever which I now have or later may have in any way resulting from, arising out of or in any way connected with my participation in the Rally.
I agree and understand that this Release extends to any and all claims I have or may have against the Released Parties with respect to the events, conditions, qualifications, instructions, rules or procedures under which the Rally is conducted, or from any other claims arising out of the Rally even if such claims result from negligence (except willful neglect) on the part of any or all of the Released Parties. I understand that this means, among other things, that I agree not to sue, attach the property of, or prosecute any claim against any of the Released Parties for any injury resulting to myself or my property during or in connection with the Rally.
I am experienced in and familiar with the operation of motorcycles and fully understand the risks and dangers inherent in motorcycling. I am voluntarily participating in the events and expressly agree to assume sole responsibility for the safe and successful operation of my motorcycle, and to accept the entire risk of any accidents, property damage, or personal injury, including death, which might be suffered as a result of my participation in the Rally.
By signing this Release, I certify that I have read this Release and fully understand it and I am not relying on any other statements or representations.
THIS IS A RELEASE OF LIABILITY.
DO NOT SIGN OR INITIAL THE RELEASE IF YOU DO NOT UNDERSTAND OR DO NOT AGREE WITH ITS TERMS.
ALL PARTICIPANTS (RIDERS AND PASSENGERS) MUST SIGN THIS RELEASE.
Print Name:___________________ Signature:__________________________
Address:______________________ Date:_______________________________
City:__________________________
State, ZIP:_____________________ W&FMC Member Number:____________
Telephone:____________________ W&FMC Chapter_____________________
E-Mail_________________________ T-Shirt Size:_________________________
Registration must be postmarked by 09 May 2008 to avoid price increases and guarantee your T-shirt order!
Registration is free, but all participants must sign the above release. Please enclose check or | ||||||