Mondak Racing::2010 Registration Forms

2011 Registration Forms

PAID MEMBER ____________

BIKE NUMBER ISSUED ____________

MON-DAK MOTORCYCLE ASSOCIATION

2011 MEMBERSHIP APPLICATION

Valid March 1st through December 31

*** PLEASE PRINT CLEARLY! FILL OUT BOTH SIDES OF APPLICATION! ***

NAME: ________________________________________________ Home Phone #: _______________________

Address: ______________________________________________ Cell Phone #: ________________________

City: _________________________ State: ______ Zip: ________ Date of Birth (age limiting classes) ________

E-mail Address: _________________________________________ Requested Bike Number: ___________

Do you wish to have your mailing and e-mail addresses released to promoters for motocross-related mailings?

YES ______ NO ________

MEMBERSHIP FEE (Riders & Nonriders)

$30 before the first race of the season and $35 after first race.

*** Mark ALL Classes You Will Participate In ***

Class Brand of Bike Engine Size

____ 50 PW Jr. or ___ 50 PW Sr. Air cooled (Jr.) liquid cooled (Sr.)

____ 65cc 6-12 yrs.

____ 85cc Beginner. Or ___85cc Amateur (both classes 7-15yrs)

____ Open Mini

____ 250 Beginner

____ Open Beginner

____ 250 Pro/Amateur Money Class

____ 450 Pro/Amateur Money Class

____ Women’s Class Limit is 8 yrs and up Minimum 65CC

____ Veteran 30+

____ Outlaw Open Money Class

____ Quads (Minimum age is 16) Money Class

All classes are trophy classes except as noted!!!

Return with proper fees to: MON-DAK MOTORCYCLE ASSOCIATION

ATTN: Promise Miller

P.O. Box 425

Baker, MT 59313

AGREEMENT BETWEEN

Mon-Dak Motorcycle Association and

NAME: ___________________________________________
(Please Print Clearly)

The undersigned participant, and in the case of a minor, or his or her lawful custodian, does hereby expressly agree and covenant unto the Mon-Dak Motorcycle Association and the local club or organization conducting any race or activity in which the participant is involved, that said participant will forever hold harmless the Mon-Dak Motorcycle Association and the local club or organization sponsoring said race or activity, together with any and all individuals assisting in the promotion of the said event, or other contestants properly authorized to participate in said events for any and all claims or demands for property damage, personal injury, or any combination thereof.

All participants expressly acknowledge and agree that no warranties, representations, or statements concerning any aspect of the activity conducted, track conditions, or otherwise, have been made as any inducement to participate in this event or any other event sanctioned by the Mon-Dak Motorcycle Association. All participants, their parent(s), lawful custodian or guardian(s), expressly acknowledge that there are risks involved with this event and they agree to assume all responsibility for injuries that may occur as a direct or indirect result of their participation.

All participants, their parent(s) lawful custodian or guardian(s), herein expressly and knowingly hold harmless the Mon-Dak Motorcycle Association, Inc., and the local club or organization conducting said activities, from any and all liability whatsoever arising as a result of the sanctioned events or any activity incidental thereto. The undersigned does further expressly acknowledge that he/she has read the forgoing agreement and understands its terms and voluntarily agrees to the terms.

Dated this ____ day of _____________________, 2011

Signature: _______________________________________________

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If less than 18 years old, bottom part MUST be signed by parent, or guardian, or lawful custodian and signed by a “Notary “

AUTHORIZATION FOR PARTICIPATION BY A MINOR MUST BE NOTARIZED

The undersigned individual represents that he or she is the lawful custodian, parent, or guardian of the above named minor person, and expressly and knowingly does hereby authorize that said minor may participate in Motorcycle races and related events as sanctioned by the Mon-Dak Motorcycle Association, Inc., and as conducted by the local club or organization. The undersigned does further expressly acknowledge that he or she read the foregoing agreement as a condition of participation, and that he/she does expressly agree to each of the covenants and terms as set forth therein and voluntarily agrees to the terms.

Dated this _____day of _____________, 2011 Date this _____day of _____________, 2011

Parents Signature: ____________________________________ Notaries Signature: ____________________

Notaries Seal: