Orting Chamber of CommerCe

2008 Festival in the Park

Cover Your ‘Wagon’ A Wagon Race
2008 COVER YOUR ‘WAGON’ RACE TEAM REGISTRATION FORM
PLEASE CIRCLE RACING DIVISION: WOMEN’S MEN’S CO-ED YOUTH 13-16 YEARS
YOUTH 7-12 YEARS 6 & UNDER
ARE YOU REPRESENTING A BUSINESS? ____YES ____NO
BUSINESS NAME

Team Name Team Leader/Contact Person

Contact Number Email Address

RACE TEAM REGISTRATION FEE: $10.00 Please circle form of payment: CASH CHECK MONEY ORDER
***Please make all checks and money orders payable to Orting Chamber of Commerce - Wagon Race***
2008 RACE TEAM WAIVER OF LIABILITY & INDEMNITY AND RELEASE FOR MEDIA
Cover Your ‘Wagon’ A Wagon Race Waiver of Liability
* I shall indicate acknowledgement/assumptions/permission/participation for self, minor child and/or ward.
I know that running/riding in a wagon race is potentially hazardous. *I should not enter or run/ride unless I am medically able and properly trained.
I also know that, although there will be security protection provided, that there may be hazards on the racecourse. I assume all risk of
running/riding on the racecourse. I also assume any and all risks associated with running/riding in this event and participating in other activities
scheduled including but not limited to falls, the effects of weather, including rain, high heat, humidity, contact with other participants, spectators
or equipment, and the condition of the roads/surfaces used for the racecourse. In consideration of your permitting me/my minor child/my ward to
participate in the Cover Your ‘Wagon’ A Wagon Race on August 16, 2008, I hereby for myself and/or for my minor child/ward, my heirs, executors,
administrators or anyone else who might claim on my behalf, covenant not to sue, and waive, release and discharge, the Cover Your ‘Wagon’ A
Wagon Race, Orting’s Festival in the Park, Orting Chamber of Commerce, City of Orting, race officials, volunteers and any sponsoring body, their
successors and assigns, any of their officials from any and all claims or cause of action I may have for all personal injuries or property damage
caused by or arising out of the Cover Your ’Wagon’ A Wagon Race and its related activities. I also agree to abide by all rules and regulations issued
by the Festival in the Park, Cover Your ‘Wagon’, a wagon race officials.
Cover Your ‘Wagon’ A Wagon Race Indemnity and release for Radio, Television and Print Media
* I shall indicate acknowledgement/assumptions/permission/participation for self, minor child and/or ward.
For sufficient consideration and the right to appear, I agree to protect and indemnify the Cover Your ‘Wagon’ A Wagon Race, Orting’s Festival in the
Park, Orting Chamber of Commerce, City of Orting, its officers, members and volunteers, and advertising agency, and their respective officers and
employees, and to hold it and them harmless from and against all liability, loss, damages, expenses, judgments, counsel fees, costs and other
damages against them or for which it or they shall become liable by virtue of or arising out of or caused by any matter or materials supplied or
spoken by me, my minor child/ward in the telecast of the Cover Your ‘Wagon’ A Wagon Race. I hereby give my permission for the Cover Your
‘Wagon’ A Wagon Race to use my picture or name, picture, or name of my minor child/ward in any publicity deemed necessary for the promotion
of the event at no compensation.
BY ATTACHING MY SIGNATURE, I HEREBY ACKNOWLEDGE RECIEPT OF THE 2008 COVER YOUR ‘WAGON’ A WAGON RACE RULES & REGULATIONS

Rider Name DOB Signature

Runner (1) Name DOB Signature

Runner (2) Name DOB Signature

Runner (3) Name DOB Signature

Runner (4) Name DOB Signature

Alternate Name DOB Signature

Parent/Guardian DOB Signature

Deadline for submitting this form is Saturday August 16, 2008 1:00 PM
No racer will be allowed to participate without signing these forms

Orting Chamber of Commerce, PO Box 1418, Orting, WA 98360 www.ortingchamberofcommerce.com