First Name: Last Name:
D.O.B.:
Street Address:
City: State: Zip:
Telephone number:
E-mail:
GMP Number:
AMA Number:
Expiration Date:
Please read the following carefully before submitting: I understand motorcycle riding is inherently dangerous and hereby agree to conform to, and comply with the rules governing competition and agree to hold blamelesss the Green Mountain Plonkers Trials Club, its officers, the contest committee, the director of contests, and/or owners of the premises for any loss or injury to myself or property, and to assume all responsibility for any loss or injury to myself and/or property in which I may become involved of by reason of my participation in events sanctioned and non-sanctioned by the Green Mountain Plonkers Trials Club. I assume full responsibility for, and the risk of, loss, damage, or injury (including death) of whatsoever kind, nature or description that may arise to my person and property notwithstanding any negligence of the Green Mountain Plonkers Trials Club, its officers, members, employees and agents, event officials, promoters, sponsors, motorcycle owners, riders, mechanics and pit crew and owners and lessees of premises used in connection with the event, and each of their respective employees and agents.
COMMENTS?