PLEASE PRINT THIS PAGE AND BRING TO CLASS

(951) 257-4598
An Up Close and More Personal Approach to Fine Tuning Your Riding Skills
Rider's Name:____________________________________________________________________
Address:_________________________________________________________________________

City:_____________________

 State: _________________ Zip: _______
Phone: (____)______________
 Birthdate: ______________ Age: _______
ENTRY FEE: COST $200 First Lesson/$150 Each Addt’l Lesson
PER DAY PER PERSON
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT IN CONSIDERATION of being permitted to compete, officiate, observe, work for, or participate in any way in the EVENT(S) or being permitted to enter for any purpose and RESTRICTED AREA (defined as any area requiring special authorization, credentials, or permision to enter or any area to which admision by the general public is restricted or prohibited), EACH OF THE UNDERSIGNED, for himself, his personal representatives, heirs and next of kin.
  1. Acknowledges, agrees, and represents that he has or will immediately upon entering any of such RESTRICTED AREAS, and will continuously thereafter, inspect the RESTRICTED AREAS which he enters and he further agrees and warrants that if at any time, he is in or about RESTRICTED AREAS and/or refuses to participate further in the EVENT(S)
  2. HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the trainer, participants, racing associations, sanctioning organizations or any subdivision thereof, track owners, officials, car owners, drivers, pit crews, rescue personnel, any persons in any RESTRICTED AREA, promoters, sponsors, advertisers, owners and lessees of premises used to conduct the SCHOOL(S), premises and school inspectors, surveyors, underwriters, consultants and others who give recommendations, directions or instructions or engage in risk evaluation or loss control activities regarding the premises or SCHOOL(S) and each of them, their directors, officers, agents and employees, all for the purpose herein referred to as "Releasees", FROM ALL LIABILITY, TO THE UNDERSIGNED, his personal representatives, assigns, heirs, and next of kin FOR ANY AND ALL LOSS OR DAMAGE, AND ANY CLAIM OR DEMANDS THEREFORE ON ACCOUNT OF INJURY TO THE PERSON OR PROPERTY OR RESULTING IN DEATH OF THE UNDERSIGNED ARISING OUT OF OR RELATED TO THE SCHOOL(S), WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
  • I HAVE READ THE ABOVE ASSUMPTION OF RISK ACKNOWLEDGEMENT, UNDERSTAND WHAT I HAVE READ AND SIGN IT VOLUNTARILY.
___________________________________________________________________________________
RIDER'S SIGNATURE DATE
___________________________________________________________________________________
PARENT OR LEGAL GAURDIAN'S SIGNATURE (If under 18) DATE
MAIL ENTRIES WITH CASHIERS CHECK OR MONEY ORDER PAYABLE TO:
KURT HENRICKSEN MOTOCROSS SCHOOL
29173 Broken Arrow Way
Murrieta, Ca 92563