Tomahawk MX, LLC Annual
Membership Application
Please write clearly and fill in all information. Parents MUST sign and have form notarized!
Name
____________________________________________ Phone (_______)______________________________Address
________________________________________ Date of Birth________ Age__________City, State, Zip
___________________________________________________________________Email ________________________________________________________________________________
Emergency Contact ____________________________________ Phone (______)_____________
Today’s Date ____________________
Membership fee:
$50.00
Annual membership for any rider of any age riding MX or ATVs. Riding Fees still apply. (See below)
|
Riding Fees: |
Gate Fees: |
|
$25.00 |
No gate fees for Open Practice. |
Tomahawk MX, LLC has the right to designate the level ability of its members
and the level of the riding areas in which a rider may participate.
In consideration of being granted membership to Tomahawk MX, LLC, and in consideration of being permitted to participate as a rider or pit crew on the premises:
1. I, for myself, my heirs, personal representative and assigns, hereby release, discharge, and agree to hold harmless and totally indemnify Tomahawk MX, LLC, the clubs, the promoters, and landowners holding and presenting Tomahawk MX, LLC events, the owner and lessee of premises on which Tomahawk MX, LLC events take place, the participants in Tomahawk MX, LLC events, the owners, sponsors, and manufacturers of all racing equipment used in such events, and the officers, directors, officials, representatives, agents, and employees of all of them from any liability, loss, claims, demands and possible causes of action that may otherwise accrue from any loss, damage or injury (including death) to my person or property, in any way resulting from, or arising in connection with, or related to any Tomahawk MX, LLC event, and whether arising while engaged in competition or in practice or in preparation therefore or while upon, entering, or departing from said premises, from any cause whatsoever including without limitation the failure of anyone to enforce rules and regulations, failure to make inspections and even gross negligence of any other persons. I know the risk and danger to myself and property while participating in events related to Tomahawk MX, LLC, upon my own judgment and ability, I assume all risks and loss, damage, or injury (including death) to myself and my property from any cause whatsoever and whether or not attribute to the gross negligence of others.
2. I agree Tomahawk MX, LLC or it’s assigns may use my name and/or pictures including pictures of my equipment for any endorsement or media.
3. I agree (subject to suspension with no reimbursements) that I will not let others use my membership card.
4. I assume all responsibility for my doctor and/or hospital expenses and any loss or injury to personal property or myself in which I may become involved in by reason of participating in Tomahawk MX, LLC events.
5. Tomahawk MX, LLC DOES NOT PROVIDE HEALTH INSURANCE. If you do not have health insurance we recommend you do not become involved in by reason of participating in Tomahawk MX, LLC events.
Health Insurance Information
Insurance Company_____________________________________________
Policy Number_________________________________________
1. I agree that any official, employee, or representative of Tomahawk MX, LLC reserves the right to reject any rider or machine who in his/her judgment is not fully qualified to participate in an event or practice.
2. As authorized adult (parent or legal guardian) I certify that all the information supplied is true and correct. It is my responsibility to have at all of Tomahawk MX, LLC events a copy of my birth certificate, and current membership to Tomahawk MX, LLC. An authorized adult must be present at all times if rider is under the age of 18.
NOTICE:
If any rider is under the age of eighteen, and this application is processed via the mail or Internet, this application must bear the notarized signature of a parent or legal guardian who shall acknowledge a waiver and release of any and all claims such parent or legal guardian may have.
As rider and/or authorized adult I certify that I have completely read this application by signing below and agree to waive and release all rights by law against Tomahawk MX, LLC.
____________________________________________
Signature of parent or legal guardian
____________________________________________
Signature of rider
Membership Fee must accompany this application.
Sworn and subscribed before me
At______________________________________________
On this______________ day of_______________, 20_____
Notary Public of__________________________________
My Commission Expires___________________________
Notary
Seal
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