MARITIME BARRELRACINGASSOCIATION WAIVERANDRELEASEOFLIABILITY

InconsiderationofbeingallowedtoparticipateinanywayinaMaritimeBarrelRacingAssociationsanctioned event,andinparticulartheJackpot/Show beingknownas The Tom Burt and Mark McGuire Memorial Jackpot, June 17th & 18th, 2017 aswellasanyandallactivitiesrelatedtosuchevent,theundersignedacknowledges,appreciatesandagreesthat

1. Theriskofinjuryfromtheactivitiesinvolvedinthistypeofeventissignificant,includingthepotentialfor permanentparalysisanddeath,andwhileparticularrules,equipmentandpersonaldisciplinemayreducethisrisk, theriskofseriousinjurydoesexistand

2. IKNOWINGLY ANDFREELYASSUMEALLSUCHRISKS,bothknownandunknown,EVENIFARISING FROMTHENEGLIGENCE OFTHERELEASEESorothers,andassumefullresponsibilityformyparticipation and

3. Iwillinglyagreetocomplywiththestatedandcustomarytermsandconditionsforparticipationin thisevent. If howeverIobserveanyunusualsignificanthazardduringmypresenceorparticipation,Iwillremovemyself from participationandbringsuchtotheattentionofthenearestofficialimmediatelyand

4. I, formyselfandonbehalfofmyheirs,assigns,personalrepresentativesand nextofkin,HEREBYRELEASE ANDHOLDHARMLESS theMaritimeBarrelRacingAssociation,theirofficers,officials,agentsand/or employees,otherparticipants,sponsoringagencies,sponsors,advertisers,and, ifapplicable,ownersandlessorsof premisesusedtoconducttheevent("Releasees"),WITHRESPECTTOANYANDALLINJURYDISABILITY, DEATH,orlossordamagetopersonorproperty,WHETHERCAUSEDBYTHENEGLIGENCEOFTHE RELEASEESOROTHERWISE.

5.Iagreetoabidebyallof therules,regulations,andpoliciesoftheMaritimeBarrelRacingAssociationwhile participatingatthisevent.

IHAVEREADTHISRELEASEOFLIABILITY ANDASSUMPTION OFRISKAGREEMENT,FULLY UNDERSTANDITSTERMS,UNDERSTAND THATIHAVEGIVENUPSUBSTANTIALRIGHTSBY SIGNINGITANDSIGNITFREELYANDVOLUNTARILY WITHOUTANYINDUCEMENT.

X ______

PARTICAPANT’S SIGNATURE

X ______Date Signed ______

For Participants of Minority Age
(Under age at the time of registration)

This is to certify that I, as a parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided.

X______
PARENT/ GUARDIANS SIGNITURE EMERGENCY PHONE NUMBER

X______
PRINT NAME NAME OF MINOR