GLOUCESTER AH&P ASSOCIATION INC

MODERN MOTORS – DEUTZ FAHR

UTE PULL

UteOwner:

Name:……………………………………………………………………………………………………………………………….Address:…………………………………………………………………………………………………………………………….Contactphone:…………………………………………………………………………………………………………………

UteDriver:

Name:……………………………………………………………………………………………………………………………….Address:…………………………………………………………………………………………………………………………….ContactPhone:………………………………………………………………………………………………………………....

Ute: MakeandModel:……………………………………………………………………………………

YearofManufacture:……………………………………………………………………………..

Classes:Atthediscretionofthesledoperator.(Pleasecircleselectedclasses) #Light #Medium #Heavy #Misc #BestPresented #WorstPresented

Indemnity-Iagreethat

1. IhavereadandwillabidebytheAH&PAssocInc.(TheAssociation)utepullrules.2. IfIsufferinjury,lossordamagewhileparticipatinginthisUtepull(TheEvent).Iwillnothold

TheAssociation,theirmembersorassistants,legallyresponsibleforanylossIsuffer.IwillnotsueTheAssociation,theirmembersorassistantsforanyclaims,costs,damagesorliability.IagreetoreleaseTheAssociation,theirmembersorassistantsfromlegal

responsibilityfortheservicesIhavebeenprovidedand/oractivityIhaveparticipatedin.

3. Myparticipationintheeventandassociatedactivitiesisdangerousandmayinherentrisksasaresultofwhichpersonalinjury(andsometimesdeath)mayoccur.Iacceptandassume

allsuchrisksofpersonalinjuryordeathinanywaywhatsoeverarisingfromtheseactivities

andherebywaivemyindividualrighttosuetheAssociation,theirmembersorassistantsforallclaimsIormyrepresentativesmayhaveforsuchpersonalinjuryordeathagainsttheAssociation,theirmembersorassistantsinanywaywhatsoeverarisingfromorinconnectionwiththeEvent.

4. AtthetimeofparticipatingintheEvent,Ihavenotbeentoanydegreeundertheinfluenceofalcoholorillicitdrugs.

5. IwillnotconsumeanyalcoholorillicitdrugswhileparticipatingintheEventandagreethatsuchusemayresultinmybeingexcludedfromTheEventwithnoentitlementtoanyrefundofentrymoniespaidtotheAssociation.

DriversSignature:……………………………………………… Date:………………………………….