Shannon Niday Motocross School
Pacific Junction, Iowa (at the Mid-American Motocross Championships track)
Friday, August 29th, 2003
9 am - 3 pm
Cost: $150
Entry Form
Please fill out completely and mail $50 deposit to: Shannon Niday Motocross School, 12384 C.R. 1114 Athens, TX 75751
Name: Age: Phone:
Address: City: State: Zip:
Email: Bike Size:
I hereby declare that it might be my intent while at this motocross school to ride at high speeds and to test my riding skills to check the performance of the vehicle I am riding.
I affirm that I am going to engage in these potentially dangerous activities of my own volition. I hereby affirm that I enter this school fully aware of the possible hazards to my person and my property therein. If I am injured, in any manner, while I am in the school, or on school grounds, I will grant full and unconditional release for any injuries sustained to my person, to all track owners, participants, officials, employees, promoters, instructors, or any others who are responsible for the activities of the school.
On behalf of heirs, my executors, administrators, or myself, I agree to hold harmless and indemnify all track owners, participants, officials, employees, promoters, instructors, or others who are responsible for the activities in the school for any damages or injury to my person or property.
PLEASE READ THE ABOVE CAREFULLY BEFORE SIGNING INTO THE SCHOOL.
I HAVE READ THIS ENTRY FORM AND FULLY UNDERSTAND THE WAIVER.
Rider's Signature____________________________________________________________________________Date:_________________
Parent's Signature___________________________________________________________________________Date:_________________
Please make checks payable to Shannon Niday