HIGH MOUNTAIN ATV ASSOCIATION INC.

2010

Rodeo Entry Form

NO NITROS-OXIDE / HELMETS REQUIRED

Name:  _____________________________________________ Age: _________

Address_____________________________________________ Zip:__________

Telephone #:__________________________e-mail: ___________________________

ATV Make:________________________________   Model:________________

REGISTRATION FEE:  $50.00 if not registered with the Jamboree.

                              Includes 5 tickets and a Rodeo shirt.

(Five tickets can be used on any of the three events) (Additional tickets $1.00 per ticket)

                                      Barrel race, Drag Race and Mud Bog

Adult:

2WD  up to 500cc_______________ over 500cc ________________

4WD  up to 500cc_________________  over 500cc _______________         

Junior: (ages 6-12) up to 90cc___________up to 125cc_________up to 350cc_____________

Teen: (ages 13-17) up to 250cc___________up to 500cc________over  500cc____________

Peewee:(5 and under) ______________

   RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT IN CONSIDERATION of being permitted to participate in any way in the sport and activities of High Mountain ATV Association, I acknowledge, appreciate, and agree that:

1.      The risk of injury from the activity and equipment involved in ATV activities is significant including the potential for permanent disability and death, and while particular protective equipment and personal discipline will minimize this risk, the risk of serious injury does exist.I knowingly and freely assume all such risks, both known and unknown ven if arising from the negligence of those persons released from liability below, and assume all responsibility for my participation; and,

2.      I understand that the activities of motorized off road activities are physically and mentally intense. I understand the rules of play and will comply with all the rules and regulations. If I observe any unusual or unnecessary hazards during my participation, I will bring such to the attention of the nearest official as soon as practical and leave the area;

3.       I, for myself and on the behalf of my heirs, assigns, personal representatives and next of kin, forever release and hold harmless High Mountain ATV Association, their officers, directors, agents, and the sponsors (“Releases”) of the off road event, and the owners of the premises (city of Wallace) used to conduct the motorized off road activities, with respect to any and all injury, disability, death or loss of damages to person or property, whether caused by the negligence of the releases or otherwise.

4.       I understand and agree that the release of liability agreement covers each and every motorized off road activity and /or event in which I participate or attend hereafter.

5.       I understand that the promoters of High Mountain ATV Jamboree do not provide health insurance. The undersigned further agrees to assume all responsibility for doctor, ambulance, hospital and medical expenses and any loss or injury to me/the minor and or personal property due to participation in any High Mountain ATV Association event.

The undersigned has read and voluntarily signed the release and waiver of liability and indemnity agreement, and further agrees that no oral representations, statements or inducements apart from the forgoing written agreement have been made.

                           I HAVE READ THIS RELEASE:

Date signed:        _____/_____/_______

Print name clearly______________________________________

Applicant’s signature___________________________________

Parent/Guardian signature______________________________

(If under 18 years of age this must be signed by the parent or guardian)