Mail-In Registration

Print and sign, include check or pay via Paypal DirtRidersOfColorado@gmail.com 
Dirt Riders of Colorado / Rocky Mountain Super Enduro June 25 2016, .
EVENT REGISTRATION/RELEASE FORM
MOTORCYCLE ACCIDENT WAIVER, RELEASE OF ALL LIABILITY AND ASSIGNMENT OF CLAIMS
As consideration for being allowed to participate in the event(s) described below I agree:
1. I acknowledge that motorcycle activity is a potentially hazardous activity which can be a test of a person’s physical and mental limits and carries with it the potential for death, serious injury and property loss.  The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of riders equipment, vehicular traffic, actions of other people including, but not limited to organizers, participants, volunteers, spectators, agents, The Dirt Riders Of Colorado and its officers, directors and employees.  These risks are not only inherent to riders, but are also present for passengers, spectators and volunteers.  I hereby assume all of the risks of participating, viewing and/or volunteering in this event.  I realize that liability may arise from negligence or carelessness on the part of the persons or entities organizing or conducting this event and hereby release them of all possible liability.  I certify I am at least 18 years old.  I promise not to sue and agree to pay all court costs and all attorney fees that result from my action, civil or otherwise. 2. In consideration of my being permitted to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me during the event or during my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: The Dirt Riders Of Colorado, officers, directors, employees, ride organizers, sponsors, representatives, agents, volunteers and (B) indemnify and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made by other individuals or entities as a result of any of my actions during this event. Accordingly, I do hereby release and discharge The Dirt Riders Of Colorado its officers, directors employees, ride organizers, sponsors, representatives and agents, and their officers, agents and its employees from all claims, demands, and causes of action of every kind whatsoever for any death, damages and /or injuries which may result from my participation in this event.  This shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. 3. I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident and or illnesses during the event(s).  I agree to pay for any and all costs related to medical response, treatment and transport on my behalf. 4. I certify I will wear the personal protective equipment while operating my motorcycle at this event in which my participation occurs and that my motorcycle and all required personal protective equipment are in safe operational condition.  I agree to abide by the directions/rules given by the organizers of this event and understand that my privilege to ride may be removed without refund if I am in violation of the rules set forth or acting/performing in an unsafe manner, or any manner disruptive to the operation of the event(s). 5. As additional consideration for being allowed to participate in the event, I hereby assign to The Dirt Riders Of Colorado any claim I have or might have, in contract or in tort in any way, shape, form or fashion arising out of its action, the actions of other riders or anyone that participates in or comes in contact with participants in the event(s).  This assignment is intended by all parties to be a full and complete assignment of any claim I have against The Dirt Riders Of Colorado and its officers, directors, employees, ride organizers, sponsors, volunteers, representatives and agents, or may have against entities and individuals listed in this paragraph whether directly or through third parties.  The intent of the parties is that The Dirt Riders Of Colorado and officers, directors, employees, ride organizers, sponsors, volunteers, representatives and agents shall be liability free with regard to anything in any way connected with the event. 6. I hereby release The Dirt Riders of Colorado from any and all claims based upon or arising out of the use, reproduction, distribution, display or performance of all or any part of the photographs or recording, or any derivative thereof, including any claim of invasion of privacy or right of publicity. I hereby certify that I have read both pages of this Waiver, Release and Assignment of Claims in its entirety.  My signature below indicates that I fully understand it and agree to its contents.

Full Signature

(Signature indicates agreement to terms and conditions)___________________________________

Printed name: ____________________________________   Date: ______________________

Last Name____________________________ First Name_______________________

Address______________________________________________

City_____________________________ State______Zip_________

Cell Phone ____________________Home Phone___________________

Email__________________________________________________

Select Class

Pro ☐ Open A☐ Open B☐

Vet +30☐ Senior +40☐

TrialCross☐ Women ☐

Motorcycle Make & Model____________________________________________________________

Engine Size ___________________

Sponsors__________________________________________________________

Pre Entry Fee is $75.00,  Second class $45

Make check payable to Dirt Riders Of Colorado

send to:  DROC, 622 Columbine Rd, Woodland Park CO 80863