SIGNATURE AND TITLE OF WITNESS ADDRESS OF WITNESS 1155 9/06

RELEASE AND WAIVER OF LIABILITY,

ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
DESCRIPTION AND LOCATION OF SCHEDULED EVENT(S)
DATE RELEASE
SIGNED
IN CONSIDERATION of being permitte to !ompete" offi!i#te" ob$er%e" &or'" or p#rti!ip#te in #n( &#( in t)e EVENT(S) or being
permitte to enter tor #n( p*rpo$e #n( RESTRICTED AREA (efine #$ #n( #re# re+*iring $pe!i#, #*t)ori-#tion" !reenti#,$" or
permi$$ion to enter or #n( #re# to &)i!) #mi$$ion b( t)e gener#, p*b,i! i$ re$tri!te or pro)ibite)" EACH OF THE UNDERSIGNED" for
)im$e,f" )i$ per$on#, repre$ent#ti%e$" )eir$" #n ne.t of 'in/
01 A!'no&,ege$" #gree$" #n repre$ent$ t)#t )e )#$ or &i,, immei#te,( *pon entering #n( ot $*!) RESTRICTED AREAS" #n
&i,, !ontin*o*$,( t)ere#fter" in$pe!t t)e RESTRICTED AREAS &)i!) )e enter$" #n )e t*rt)er #gree$ #n &#rr#nt$ t)#t" if #t
#n( time" )e i$ in or #bo*t RESTRICTED AREAS #n )e fee,$ #n(t)ing to be *n$#fe" )e &i,, immei#te,( #%i$e t)e offi!i#,$ of $*!)
#n if ne!e$$#r( &i,, ,e#%e t)e RESTRICTED AREAS #n2or ret*$e to p#rti!ip#te t*rt)er in t)e EVENT(S)1
31 HERE45 RELEASES"6AIVES" DISCHARGES AND COVENANTS NOT TO SUE t)e promoter$" p#rti!ip#nt$" r#!ing #$$o!i#tion$"
$#n!tioning org#ni-#tion$ or #n( $*bi%i$ion t)ereot" tr#!' oper#tor$" tr#!' o&ner$" offi!i#,$" !#r o&ner$" ri%er$" pit !re&$" re$!*e
per$onne," #n( per$on$ in #n( RESTRICTED AREA" $pon$or$" #%erti$er$" o&ner$ #n ,e#$$ee$ of premi$e$ *$e to !on*!t t)e
EVENT(S)" premi$e$ #n e%ent in$pe!tor$" $*r%e(or$" *ner&riter$" !on$*,t#nt$ #n ot)er$ &)o gi%e re!ommen#tion$" ire!tion$"
or in$tr*!tion$ or eng#ge in ri$' e%#,*#tion or 7,o$$ !ontro, #!ti%itie$ reg#ring t)e premi$e$ or EVENT(S) #n e#!) of t)em" t)eir
ire!tor$" offi!er$" #gent$" emp,o(ee$" repre$ent#ti%e$" o&ner$" member$" #ffi,i#te$" $*!!e$$or$ #n #$$ign$ #,, tor t)e p*rpo$e$
)erein reterre to #$ 8Re,e#$ee$"8 FRO9 ALL LIA4ILIT5 TO THE UNDERSIGNED" )i$ per$on#, repre$ent#ti%e$" #$$ign$" )eir$" #n
ne.t of 'in FOR AN5 AND ALL LOSS OR DA9AGE" AND AN5 CLAI9 OR DE9ANDS THEREFOR ON ACCOUNT OF IN:UR5 TO
THE PERSON OR PROPERT5 OR RESULTING IN DEATH OF THE UNDERSIGNED ARISING OUT OF OR RELATED TO THE
EVENT(S)" 6HETHER CAUSED 45 THE NEGLIGENCE OF THE RELEASEES OR OTHER6ISE1
;1 HERE45 AGREES TO INDE9NIF5 AND SAVE AND HOLD HAR9LESS t)e Re,e#$ee$ #n e#!) of t)em FRO9 AN5 LOSS"
LIA4ILIT5" DA9AGE" OR COST t)e( m#( in!*r #ri$ing o*t of or re,#te to t)e UNDERSIGNED<S IN:UR5 OR DEATH" 6HETHER
CAUSED 45 THE NEGLIGENCE OF THE RELEASEES OR OTHER6ISE1
4. HERE45 ASSU9ES FULL RESPONSI4ILIT5 FOR AN5 RIS= OF 4ODIL5 IN:UR5" DEATH OR PROPERT5 DA9AGE
#ri$ing o*t of or re,#te to t)e EVENT(S) &)et)er !#*$e b( t)e NEGLIGENCE OF RELEASEES or ot)er&i$e1
>1 HERE45 #!'no&,ege$ t)#t THE ACTIVITIES OF THE EVENT(S) ARE VER5 DANGEROUS #n in%o,%e t)e ri$' of $erio*$
in?*r( #n2or e#t) #n2or propert( #m#ge1 E#!) of THE UNDERSIGNED" #,$o e.pre$$,( #!'no&,ege$ t)#t IN:URIES
RECEIVED 9A5 4E CO9POUNDED OR INCREASED 45 NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE
RELEASEES1
@1 HERE45 #gree$ t)#t t)i$ Re,e#$e #n 6#i%er of Li#bi,it(" A$$*mption of Ri$' #n Inemnit( Agreement e.ten$ to #,, #!t$ #t
neg,igen!e b( t)e Re,e#$ee$" INCLUDING NEGLIGENT RESCUE OPERATIONS #n i$ intene to be #$ bro# #n in!,*$i%e #$ i$
permitte b( t)e ,#&$ of t)e St#te or Pro%in!e in &)i!) t)e E%ent($) i$2#re !on*!te #n t)#t if #n( portion t)ereof i$ )e, in%#,i" it
i$ #gree t)#t t)e b#,#n!e $)#,," not&it)$t#ning" !ontin*e in f*,, ,eg#, for!e #n effe!t1
7. HERE45 #!'no&,ege$ t)#t t)e *ner$igne )#$ t)e rig)t to negoti#te t)e term$ #n !onition$ of t)i$ re,e#$e #greement
b*t b( $igning be,o& )ereb( &#i%e$ $*!) rig)t1
I HAVE READ THIS RELEASE AND 6AIVER OF LIA4ILIT5" ASSU9PTION OF RIS= AND INDE9NIT5 AGREE9ENT" UNDERSTAND
ITS TER9S" UNDERSTAND THAT I HAVE GIVEN UP SU4STANTIAL RIGHTS 45 SIGNING IT" AND HAVE SIGNED IT FREEL5 AND
VOLUNTARIL5 6ITHOUT AN5 INDUCE9ENT" ASSURANCE OR GUARANTEE 4EING 9ADE TO 9E AND INTEND 95 SIGNATURE
TO 4E A CO9PLETE AND UNCONDITIONAL RELEASE OF ALL LIA4ILIT5 TO THE GREATEST EATENT ALLO6ED 45 LA61
ALL SECTIONS MUST BE COMPLETED.
PRINT NAME HERE SIGN NAME HERE DUTIES