Club rules:  Vehicle must pass safety inspection.  All drivers must fill out a registration form.  Driver must follow all rules given at the drivers’ meeting.  Any driver that does not follow these rules or causes conflicts with officials or other drivers will be told to leave immediately.

Mountain Jacks, its members, and officials assume no responsibility for any vehicle damage or personal injury that may result from participating in any club event.  The undersigned agrees that off road racing involves serious risks and that he/she is fully responsible for participation

Name


Address


                              Street                                                                               City                                                 State                               Zip


Vehicle Name


Vehicle Type


                                    Year                                   Make                                        Model                                        Engine                     Weight


Sponsors


 


Club Affiliation


Special Thanks

EVENT ENTERED

Drags _______     Tuff Truck _______     Mud Bog _______     Trials Course _______     Other _______

Declared Class _______________________________________________________________________

Vehicle Information ____________________________________________________________________

                                                 Weight                                         Engine C.I.D.                                                  Wheelbase

Mountain Jacks Off Road Race Application

Date __________          Signature _________________________________

Mountain Jacks Release and Indemnification

             Off-road racing involves potentially hazardous activities which may include risks such as, but not limited to, falls, contact with other participants, effects of weather, traffic and other conditions.  In consideration of being allowed to participate in this event, I hereby expressly assume all risks, including personal injury and death, arising out of my participation in off-road racing and related activities.

             I agree, for myself, my heirs, executors and administrators , to not sue and to release, indemnify and hold harmless, Mountain Jacks Off-Road Club, its affiliates, officers, directors, volunteers, and employees and all sponsoring businesses and organizations and their agents and employees, from any and all liability, claims, demands, and causes of action whatsoever, arising out of my participation in this event and related activities — whether it results from the negligence of any of the above or from any other cause.

             The foregoing release and indemnification agreement shall be as broad and inclusive as is permitted by the State or Province in which the event is conducted.  If any portion of it is held invalid, the balance shall continue in full force and effect.

I have read, understand and agree to the terms of this Agreement.

______________________________________________________         ____________________

Participant’s Printed Name                                   Signature                                                                                     Date

 

I am the legal guardian of the Participant, and I hereby consent to his/her participation.  I have read the foregoing release and indemnification agreement and I hereby agree on behalf of myself and the Participant to its terms.

 

______________________________________________________         ____________________

Parent/Guardian’s Printed Name                          Signature                                                                                     Date

 

______________________________________________________         ____________________

Passenger/Pit Crew                                                 Signature                                                                                   Date

 

______________________________________________________         ____________________

MAIL COMPLETED REGISTRATION TO:

Mountain Jacks Off Road Club

P.O. Box 654

Frenchtown, MT 59834

ENCLOSE CHECK MADE PAYABLE TO MOUNTAIN JACKS OFF ROAD CLUB:

Member:                         $25.00

Non-Member                   $35.00

ONE FORM PER DRIVER.  BOTH PAGES MUST BE COMPLETED AND SIGNED.  PLEASE MAIL ONE WEEK PRIOR TO RACE TO ALLOW ADEQUATE MAILING TIME.

Pre-registered drivers must check in with Tech for each race to verify registration and qualification.