MINOR’S ASSUMPTION OF RISK ACKNOWLEDGEMENT

 

For all sanctioned races (W.K.S.R.A. INC.) Dec. 1, 2009 through Mar. 31, 2010

 

 

 

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DECRIPTION AND LOCATION OF EVENT(S)

    

 

 

I have obtained my parent’s consent to participate in the above event(s). I understand that I am assuming all of the risks if I get hurt during the event(s), and I state the following:

 

1.       Both my parents and I believe I am qualified to participate in the event(s). I will inspect the premises and equipment and if, at any time, I feel anything to be unsafe, I will immediately leave and refuse to participate further in the event(s).

 

  1. I understand that the ACTIVITIES OF THE EVENT ARE VERY DANGEROUS and INVOLVE RISKS AND DANGERS OF MY BEING SERIOUSLY INJURED OR HURT, MY BEING PARALYZED OR KILLED.

 

  1. I know that these risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the event(s), the rules of the event(s), the condition and layout of the premises and equipment, or the negligence of others, including those persons responsible for conducting the event(s).

 

 

 

I HAVE READ THE ABOVE ASSUMPTION OF RISK ACKNOWLEDGEMENT, UNDERSTAND WHAT I HAVE READ, AND SIGN IT VOLUNTARILY.

 

 

 

 

 

 

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SIGNATURE OF MINOR PARTICIPANT                                                             DATE

   

 

 

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PRINTED NAME OF MINOR PARTICIPANT                                                        AGE

   

  

 

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WITNESS   SIGNATURE                                               PRINTED NAME OF WITNESS