Kart Membership Form

Membership ApplicationMAIL TO: MVS

200804 North 150 West

Jerome, Idaho 83338

208-734-3700

Name: Email: ______

Mailing Address: ______City and State:______Zip Code + 4______Home Phone: Work Phone: Cell Phone: ______

Age: Date of Birth: Sex: M F

Circle membership fee paid: $115.00 per year for Single Member (over age 18), and $135.00 per year for Family Membership Note: Minors cannot be a single member of Magic Valley Karters

Family Members:

Name:______Relationship:______

Age:______Date of Birth:______Sex: M F

Name:______Relationship:______

Age:______Date of Birth:______Sex: M F

Name:______Relationship:______

Age:______Date of Birth:______Sex: M F

Name:______Relationship:______

Age:______Date of Birth:______Sex: M F

Name:______Relationship:______

Age:______Date of Birth:______Sex: M F

Please read and sign the Release and Waiver of Liability, Assumption of Risk and

Indemnity Agreement on the back. Please NOTE that your signature states that you

have read and clearly understand the agreement.

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMINTY AGREEMENT

IN CONSIDERATION of being permitted to practice, compete, officiate, observe, work for,

or participate in any way in an official or unofficial organized or unorganized

PRACTICE or EVENT(S) or being permitted to enter for any purpose and RESTRICTED AREAS

(defined as any to enter any area to which special authorization such as but not

limited to the Magic Valley Karters asphalt track and grounds, credentials, or

permission to enter any area to which admission by the general public is restricted

or prohibited), THE UNDERSIGNED, for himself, his personal representatives, heirs,

and next to kin:

1. Acknowledges, agrees, and represents that he has or swill immediately or

upon entering any of such RESTRICTED AREAS (such as but not limited to the Magic

Valley Karters asphalt track and grounds), which he enters and he further agrees

and warrants that, if at any time, he is in or about RESTRICTED AREAS

(such as but not limited t the Magic Valley Karters asphalt track and grounds)

and he feels anything to be unsafe, he will immediately advise the Magic Valley

Karters official s of such and will leave the RESTIRICTED AREAS

(such as but not limited to the Magic Valley Karters asphalt track)

and/or refuse to participate further in the PRACTICE, or the EVENT(S).

I HAVE READ AND UNDERSTOOD: _____

2. HEREBY RELEASE,WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the promoters,

participants, racing associations, sanctioning organizations or any subdivision thereof,

track operators, track owners, officials car owners, go kart owners, drivers, pit crews,

rescue personnel, any persons in any RESTRICTED AREAS (such as but not limited to the

Magic Valley Karters asphalt track and grounds), promoters, sponsors, advertisers,

Magic Valley Karters, owners and lessees of premises used in an official or unofficial

organized or unorganized PRACTICE, OR EVENT(S) and each of them, their directors,

officers, agents, and employees, all for the purposes herein referred to as “RELEASEES”,

FROM ALL LIABILTY, TO THE UNDERSIGNED, his personal representatives, assigns, heirs, and

next of kin FOR ANY AND ALL LOSS OR DAMAGE, AND ANY CLAIM OR DEMANDS THEREFOR ON ACCOUNT

OF INJURY TO THE PEROSN OR PROPERTY OR RESULTING IN DEATH OF THE UNDERISGNED ARISING OUT

OF OR RELATED TO OFFICIAL OR UNOFFICILA ORGANIZED OR UNORGANIZED PRACTICE OR EVENT(S)

WHETHER CASUED BY THE NEGLIGENCE OF THE RELEASEES OR OTHER WISE. I HAVE READ AND

UNDERSTOOD:______

3. HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the Releasees and each

of them FROM ANY LOSS, LIABILITY, DAMAGE, OR COST they may incur arising out of or

related to OFFICIAL OR UNOFFICIAL ORGANIZED OR UNORGANIZED PRACTICE OR EVENT(S),

WHETHER CASUED BY THE NEGLIGENCE FO THE RELEASEES OR OTHERWISE. I HAVE READ AND

UNDERSTOOD:______

4. HEREBY ASSUMES FULL RESPONSIBILITY FOR ANY RISK OF BODILY INJURY, DEATH, OR

PROPERTY DAMAGE ARISING OUT OF OR RELATED TO OFFICIAL OR UNOFFICIAL ORGANIZED OR

UNORGANIZD PRACTICE OR EVENT(S), WHETHER CASUED BY THE NEGLIGENCE OF THE RELEASEES

OR OTHERWEISE. I HAVE READ AND UNDERSTOOD:______

5. HEREBY acknowledges that THE ACTIVITES OF AN OFFICIAL OR UNOFFICIAL ORGANIZED

OR UNORGANIZED PRACTICE OF EVENT(S) ARE VERY DANGEROUS And involve the risk of serious

injury and/or death and/or property damage. THE UNDERSIGNED also expressly acknowledges

the INJURIES RECEIVED MAY BE COMPUNDED OR INCREASED BY NEGLGEN RESCUE OPERATIONS OR

PROCEDURES OF THE RELEASEES. I HAVE READ AND UNDERSTOOD:____

6. HEREBY agrees that this Release and waiver of Liability, assumption of Risk

and Indemnity Agreement extends to all acts of negligence by the Releasees, INCLUDING

NEGLIGENT RESCUE OPERATIONS and is intended to be as broad and inclusive as is

permitted by the laws of the Province or State in which the OFFICIAL OR UNOFFICIAL

ORGANIED OR UNORGANIZED PRACICE OR EVENT(S) is/are conducted and that in any portion

thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue

in fell legal force and effect,. I HAVE READ AND UNDERSTOOD:____

I HAVE READ THIS RELEASE AND WAIVER OF LIABILTY, ASSUMPTION OF RISK AND INDEMNITY

AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAN THAT I HAVE GIVER UP SUBSTANTIAL

RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT,

ASSURANCE OR GUARANTEE BEING MADE TO ME AND INTEDN MY SIGNATURE TO BE A COMPLETE AND

NCONDTIONOAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

PRINT NAME HERE: ______DATE: ______

SIGN NAME HERE: ______DATE:______

Membership Agreement

If accepted as a member by Magic Valley Karters, I agree to abide by the

By-Laws and Regulation of the Organization. I understand that my annual membership

dues entitle me to participate in all events sponsored or sanctioned by the Magic Valley

Karters and to ACTIVELY ATTEND CLUB MEETINGS. I will receive an official copy of the

current rules and regulations and a Magic Valley Karters membership card. I understand

that all publications of Magic Valley Karters will be sent to me as published during my

membership.

PRINT NAME HERE: ______DATE: ______