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KansasKrawlers KK9, 5149 S.E. Stanley Rd., Tecumseh, KS 66542
The Kansas Krawlers present...
9
th
Annual
Kansas Krawl
September 17, 2011
Tuttle Creek ORV Area
Pre-Registration $40
You may also register on-site the evening of September 16 and the morning of September 17
Onsite Registration Fee: $50
100% Payout
Driver:
First Name:
Last Name:
Address 1:
Address 2:
City:
State:
Zip Code:
Phone Number:
E-Mail:
Emergency Contact:
First Name:
Last Name:
Phone Number:
Pre-Registration Fee:
$
40
.
00
(Save $10)
One Meal Ticket Included
Extra Meal Tickets at $6.00 ea
One T-Shirt included
SM
MED
LG
XL
XXL
3X
Extra T-Shirts at $10.00 each
Trail Requested:
Novice
Intermediate
Experienced
Extreme
Trails 1-3 Trails Rated 4-7 Trails Rated 8-9 Trails Rated 10+
Competitions Requested:
Large Tire Class (37" tires and up)
Little Tire Class (36.5" tires and smaller)
Alcohol is prohibited in the Tuttle Creek ORV Area. Anyone found to be in possession of alcohol, firearms, or illegal drugs on any trail, will forfeit any and all registration fees and be denied further participation in the the event.
THIS IS A RELEASE OF LIABILITY - READ CAREFULLY BEFORE SIGNING THIS BINDING AGREEMENT Kansas Krawlers Waiver, Release of Liability, Assumption of Risk and Indemnity Agreement In consideration of Kansas Krawlers, their members, agents, officers, employees and other associates furnishing services, materials and/or equipment to enable me to participate in an off-pavement event and/or guided trail ride and/or any other associated activities, scheduled or unscheduled, I agree as follows: I understand and acknowledge that: (a) risks and dangers exist in the use of any motorized vehicle for off-pavement driving or other related activities, scheduled or unscheduled, of which I may partake as a part of, prior to, or after participation in the present event; (b) my participation in such activities and/or use of such equipment may result in injury or illness including, but not limited to bodily injury, disease, strains, fractures, partial and/or total paralysis, death or other ailments that could cause serious disability; (c) these risks and dangers may be caused by the negligence of the members, employees, officers, or agents of Kansas Krawlers, the negligence of the participants, the negligence of others, accidents, breaches of contract, the forces of nature or other causes; (d) these risks and dangers may arise from foreseeable or unforeseeable causes; and (e) by my participation in these activities and/or use of equipment, I HEREBY ASSUME ALL RISKS AND DANGERS AND ALL RESPONSIBILITY FOR ANY LOSSES AND/OR DAMAGES, whether caused in whole or in part by the negligence or other conduct of the members, agents, officers, or employees of Kansas Krawlers. I, on behalf of myself, my personal representatives and my heirs, hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify Kansas Krawlers, and their members, agents, officers, employees and other associates from all claims, suits, or causes of action for bodily injury, property damage, wrongful death, loss of services or otherwise which may arise out of my participation in these activities which include, but are not limited to, the use of off-pavement driving or any other related activities, scheduled or unscheduled. I specifically understand that I am waiving and forever releasing and discharging Kansas Krawlers. and their members, agents, officers, or employees from any and all claims or causes of action that I may have presently or which may arise in the future. This waiver and release is effective for all acts, negligent or otherwise, and conduct by Kansas Krawlers. and their members, agents, officers, or employees. I agree that, should any claim or action arise from my participation as described herein, including any issue as to the applicability of this Release or any provision contained within it, proper Jurisdiction and Venue will lie only in Shawnee County, Kansas and I waive Jurisdiction and Venue anywhere else. Assignee understands that Kansas Krawlers members, agents, officers, employees and other associates may take photographic and/or other electronic images of its events. Assignee hereby agrees that all photographs or other images obtained in any manner by Kansas Krawlers members its agents, employees or associates are the property of the photographer. The photographer and Kansas Krawlers reserve the right to use these images for promotion and/or any other legal purposes. Assignee hereby waives all rights to said images and releases, remises and forever discharges, Kansas Krawlers. its' agents, employees, officers, directors, shareholders and servants from any and all demands, actions, causes of actions, suits, damages, costs, and any other claims that may arise regarding said images or their use. I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT I AGREE IT IS MY INTENTION TO EXEMPT AND RELIEVE Kansas Krawlers FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE. I FURTHER EXPRESSLY AGREE THAT THE FOREGOING WAIVER AND RELEASE OF LIABILITY IS INTENDED TO BE AS BROAD AND INCLUSIVE AS IS PERMITTED BY LAW OF THE PROVINCE OR STATE IN WHICH SERVICES, MATERIALS AND/OR EQUIPMENT ARE PROVIDED, AND THE COURSE OF BUSINESS IS CONDUCTED, AND THAT IF ANY PORTION THEREOF IS HELD INVALID, IT IS AGREED THAT THE BALANCE SHALL, NOTWITHSTANDING, CONTINUE IN FULL LEGAL FORCE AND EFFECT. I HAVE READ THIS WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. I CERTIFY THAT THE VEHICLE(S) I BRING TO THIS EVENT IS/ARE LAWFULLY REGISTERED, INSPECTED, AND INSURED, AND THAT I HAVE NO KNOWLEDGE OF ANY CONDITION THAT MIGHT RENDER THE VEHICLE(S) UNSAFE IN ANY WAY. ADDITIONALLY, I CERTIFY THAT I AM PHYSICALLY AND MENTALLY HEALTHY AND HAVE NO CONDITION THAT WILL PUT ME AT RISK WHILE PARTICIPATING IN ANY ACTIVITIES, SCHEDULED OR UNSCHEDULED, AS HEREIN DESCRIBED. X____________________________________________________ ____________________________ PARTICIPANT'S SIGNATURE DATE SIGNED ____________________________________________________ PLEASE PRINT NAME - MUST BE LEGIBLE