Loading...

This document contains a release of all claims for property damage, personal injury and death. Please read and consider it carefully before signing


I AM AWARE THAT OPERATING OR OBSERVING A VEHICLE IN A COMPETITION MOTORSPORTS

EVENT IS A DANGEROUS ACTIVITY INVOLVING RISKS OF SERIOUS PERSONAL INJURY AND

DEATH, AND I AM VOLUNTARILY PARTICIPATING IN EVENT ACTIVITIES WITH KNOWLEDGE OF

THE DANGER INVOLVED. I HEREBY AGREE TO ACCEPT ANY AND ALL RISKS OF PROPERTY

DAMAGE, PERSONAL INJURY AND DEATH. 

As an event participant, spectator and/or guest, I HEREBY ACKNOWLEDGE AND AGREE:

that I have asked to participate in a motorsports event managed by John Waterman Jr. (“JW”) at 597

Milestrip Rd, Irving, NY 14081 (the “venue”). My “Participation&quote; includes any and all activities

involved with the transport, unloading, and operation of my vehicle to, at or from the event.

IN CONSIDERATION of being allowed to participate in the event and use of the venue’s facilities, I hereby agree to assume all risks permitted by law and I agree for myself and on behalf of my heirs, guardians, legal and personal representatives and assigns to make no claim, or sue, or otherwise prosecute JW, The Big Indian Smoke Shop or Eric R. White (the owner of the venue, hereafter, “ERW”), or their representatives, or any affiliated organizations, other participants, employees, agents, officers, directors, owners, successors, or assigns, for any injury, damages, or death resulting from negligence or any other cause, upon or as a result of my participation in the “Big Indian Drift Event” (the “event”). Further, I hereby release and forever discharge JW, The Big Indian Smoke Shop or ERW, any affiliated organizations, participants, employees, agents, officers, directors, owners, successors and assigns from all liability, actions, claims, and demands for myself and on behalf of my heirs, guardians, assigns, legal and personal representatives, that may hereafter exist for any injury, property damage or death whether from negligence or howsoever caused or resulting in any manner upon or from my participation in the event. I further agree that this Agreement and Release of Liability is intended to be as broad and inclusive as is permitted by law and that if any portion hereof is held invalid, the balance shall continue in full legal force and effect.

VEHICLE PREPARATION - I attest that I have inspected the mechanical condition of my vehicle to be used at the event and deem it to be safe, free of any fluid leaks and mechanically sound. I also understand and agree that the operational condition of my vehicle is my responsibility solely, and that if damages, injuries, or deaths occur as a result of my vehicle’s condition and/or mechanical failure(s), none of JW, The Big Indian Smoke Shop nor ERW are responsible. It is my responsibility as a participant to determine if I am qualified to inspect and certify that my vehicle is safe to operate at the event. If I am not capable or qualified, then I understand and agree that it is my responsibility to hire a qualified mechanic to conduct a safety inspection and certify that my vehicle is safe for the event’s competition operation. My submission of the ‘Tech Inspection Summary’ further certifies that I understand and agree to these terms.

SAFETY AND PROPERTY DAMAGE - I understand that JW, The Big Indian Smoke Shop or ERW do not guarantee the safety of any participant, nor do JW, The Big Indian Smoke Shop or ERW assume responsibility for the actions of any participant, spectator or staff member during the event. As a participant, guest, or spectator, I also agree to and accept full financial responsibility for any damages I or my vehicle may cause to the venue or another participant’s property. [Initial]

INSURANCE - JW, The Big Indian Smoke Shop and ERW do not provide medical or vehicle insurance. As a participant, guest, or observer, I agree to provide my own medical, vehicle, and property damage insurance. Initial

WEATHER – The event may operate regardless of weather. Participants are not required to participate in any fashion, under any weather conditions whatsoever. When, and/or whether to participate is left entirely to the judgment of the participant and they assume all risk of injury and/or property damage to themselves and other participants. [Initial]

I further covenant not to initiate a lawsuit or administrative complaint or charge or commence any sort of action or proceeding whatsoever against JW, The Big Indian Smoke Shop or ERW, their respective heirs, personal representatives, successors and assigns at any time in the future based on any right or claim that arose on or before the effective date of this Agreement.

Indemnification

I hereby agree to indemnify and hold JW, The Big Indian Smoke Shop and ERW harmless from and against any and all claims, liabilities, losses, demands, attorney fees and court costs from any actions arising from any property damage or any personal injury to, or death to, any persons, including but not limited to the undersigned, as a result of my, or my licensees, invitees, guests or members of my family, participating in any manner whatsoever, in the event. This provision includes my agreement to hold JW, The Big Indian Smoke Shop and ERW harmless from any damage, loss or injury either to person or property, or both, resulting from contact with or the actions or conduct of any equipment or animals located at or in the custody or control of or in connection with the venue.

Entire Agreement; Modification

This Agreement shall be governed by and interpreted under the laws of the Seneca Nation of Indians. The undersigned has read and fully understands the statements made above and voluntarily signs this Agreement. This instrument reflects the entire Agreement and understanding of the parties, and no statements, promises or inducements made by or on behalf of JW, The Big Indian Smoke Shop or ERW not contained herein shall be valid or binding. Any modification to this Agreement must be in writing and signed by me and JW.

Effect; Severability

This document is binding upon the undersigned, and the undersigned’s heirs, successors, assigns, executors and personal representatives. If any portion of this Agreement is held invalid, it is agreed that the balance of the Agreement shall continue in full force and effect.

Nature of Agreement

The undersigned executes and delivers this release and covenant not to sue agreement and instrument in order to induce JW, The Big Indian Smoke Shop or ERW to permit the undersigned’s participation at or in the event.

I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS DOCUMENT IS A COVENANT NOT TO SUE AND RELEASE OF LIABILITY REGARDLESS OF NEGLIGENCE OR FAULT AND IS A CONTRACT BETWEEN MYSELF AND ERW FOR THE BENEFIT OF JW, BIG INDIAN SMOKE SHOP AND ERW, ANY AFFILIATED ORGANIZATIONS, PARTICIPANTS, EMPLOYEES, AGENTS, OFFICERS, DIRECTORS, SUCCESSORS AND ASSIGNS IN WHICH I AM GIVING UP SUBSTANTIAL LEGAL RIGHTS, AND I ACKNOWLEDGE VOLUNTARILY SIGNING THIS AGREEMENT.


July 26, 2024

I Agree





First Participant's / and or spectator's Name

First Name*

Last Name*

Phone*
First Participant's / and or spectator's Age Acknowledgment*
First Participant's / and or spectator's Date of Birth*
I certify that I am 18 years of age or older
First Participant's / and or spectator's Signature*
Second Participant's / and or spectator's Name

First Name*

Last Name*
Second Participant's / and or spectator's Date of Birth*
Third Participant's / and or spectator's Name

First Name*

Last Name*
Third Participant's / and or spectator's Date of Birth*
Fourth Participant's / and or spectator's Name

First Name*

Last Name*
Fourth Participant's / and or spectator's Date of Birth*
Fifth Participant's / and or spectator's Name

First Name*

Last Name*
Fifth Participant's / and or spectator's Date of Birth*
Sixth Participant's / and or spectator's Name

First Name*

Last Name*
Sixth Participant's / and or spectator's Date of Birth*
Seventh Participant's / and or spectator's Name

First Name*

Last Name*
Seventh Participant's / and or spectator's Date of Birth*
Eighth Participant's / and or spectator's Name

First Name*

Last Name*
Eighth Participant's / and or spectator's Date of Birth*
Ninth Participant's / and or spectator's Name

First Name*

Last Name*
Ninth Participant's / and or spectator's Date of Birth*
Tenth Participant's / and or spectator's Name

First Name*

Last Name*
Tenth Participant's / and or spectator's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.

This is to certify that I, as parent/guardian with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of the activity and his/her responsibilities for adhering to the rules and regulations. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s/ward’s involvement or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.




By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!