Austin Jeep Exclusive Waiver & Registration Form

AJE Waiver

Owner / Driver

First

Last

Address

Street

City

State

Zip

Phone

Cell

Release & Waiver of Liability and Indemnity Agreement to AUSTIN JEEP EXCLUSIVE

In consideration of being permitted to participate in any event sponsored, promoted, or directed by AUSTIN JEEP EXCLUSIVE (the association), the undersigned for him/herself, his/her personal representatives, heirs, and next of kin, HEREBY RELEASES the association, officers, directors, promoters, sponsors, and members of the association of all liability to the undersigned, his/her personal representatives, heirs, and next of kin for any loss or damage on account of injury to the undersigned whether caused by the negligent act or omission of Releases or otherwise while the undersigned is for any purpose participating in such event.  It is fully understood by each of the undersigned that there is some inherent risk associated with this event, including damage to vehicles.

IN ADDITION, the undersigned AGREES TO INDEMNIFY AND HOLD HARMLESS the Releases from any loss, liability damage, or cost they incur due to such participation by the undersigned, whether caused by Releases’ negligence or otherwise and AGRESS TO ASSUME FULL RESPONSIBILITY AND RISK for any bodily injury, death, or property damage from Releases’ negligence or otherwise while undersigned is participating in this event.

IN SIGNING THIS RELEASE, EACH OF THE UNDERSIGNED HEREBY ACKNOWLEDGES AND REPRESENTS THE FOLLOWING:
     1.  That he/she has read the foregoing Release and Waiver of Liability and Indemnity Agreement.
     2.  That he/she shall at all time, while riding in a vehicle participating in this event, wear their respective seat and shoulder belts, if available.
     3.  That the owner/driver certifies that he/she has inspected this vehicle and same is in good mechanical condition.
     4.  That the owner/driver has informed him/herself about the event and trail involved in the event, either by prior participation or by investigation into the event and trail.

ALL PARTICIPANTS MUST SIGN WAIVER.  (For a participant under the age of 18 years of age, both parents, the parent with legal custody, or the minor’s legal guardian must sign this release form and write the word “minor” and age next to the minor’s name.)

Jeep

Year

Model

Color

License Plate #

State

Owner/Driver Signature

Date

Date

Printed Name

Printed Name

First

First

Last

Last

Age

(if minor)

Signature

Date

Printed Name

Printed Name

First

First

Last

Last

Age

(if minor)

Signature

Date

Printed Name

Printed Name

First

First

Last

Last

Age

(if minor)

Signature

Date

Printed Name

Printed Name

First

First

Last

Last

Age

(if minor)

Signature

reCAPTCHA

If you are human, leave this field blank.