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RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT BY SIGNING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE.

PLEASE READ CAREFULLY!

Description and location of scheduled event(s) (the “EVENT”): 2024 Flat Track Canada Membership

Date release signed: December 26, 2024

 In full or partial consideration for allowing me to participate in all related events and activities of the EVENT, I hereby warrant and agree that:

1. I am familiar with and accept that there is the risk of serious injury and death in participation, whether as a competitor, student, official or worker, in all forms of motor sport and in particular in being allowed to enter, for any reason, any restricted area; and

2. I have satisfied myself and believe that I am physically, emotionally and mentally able to participate in this EVENT, and that my protective clothing, gear and equipment is fit and appropriate for my role as a participant in this EVENT; and

3. I understand that all applicable rules for participation must be followed, regardless of my role, and that at all times during the EVENT the sole responsibility for my personal safety remains with me; and

4. I will immediately remove myself from participation, and notify the nearest official, if at any time I sense or observe any unusual hazard or unsafe condition or if I feel that I have experienced any deterioration in my physical, emotional or mental fitness, or that of my protective clothing, gear or equipment, for continued safe participation in the EVENT.

I UNDERSTAND AND AGREE, ON BEHALF OF MYSELF, MY HEIRS, ASSIGNS, PERSONAL REPRESENTATIVES AND NEXT OF KIN THAT MY EXECUTION OF THIS DOCUMENT CONSTITUTES:

1. AN UNQUALIFIED ASSUMPTION BY ME OF ALL RISKS associated with my participation in the EVENT even if arising from the negligence or gross negligence, including any compounding or aggravation of injuries caused by negligent rescue operations or procedures, of the Releasees, as that term is defined below, and any persons associated therewith or otherwise participating in the EVENT in any capacity; and

2. A FULL AND FINAL RELEASE AND WAIVER OF LIABILITY AND ALL CLAIMS that I have, or may in the future have, against any person(s), entities or organization(s) associated in any way with the EVENT including the track owners and lessees, promoters, sanctioning bodies, racing associations, or any subdivision thereof, track operators, sponsors, advertisers, car owners and other participants, rescue personnel, event inspectors, underwriters, consultants and others who give recommendations, directions or instructions or engage in risk evaluation and loss control activities, regarding the EVENT or event premises, or any one or more of them and their respective directors, officers, employees, guides, contractors, agents and representatives (all of whom are collectively referred to as “the Releasees”) from any and all liability for any loss, damage, injury or expense that I may suffer as a result of my use of or my presence at the event facilities or my participation in any part of, or my presence in any capacity at, the EVENT, due to any cause whatsoever, INCLUDING NEGLIGENCE, GROSS NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE OWED UNDER THE RELEVANT OCCUPIERS LIABILITY ACT ON THE PART OF THE RELEASEES.

3. AN AGREEMENT NOT TO SUE THE RELEASEES for any loss, injury, costs or damages of any form or type, howsoever caused or arising, and whether directly or indirectly from my participation in any aspect(s) of the EVENT; and

4. AN AGREEMENT TO INDEMNIFY, and to SAVE and HOLD HARMLESS the RELEASEES, and each of them, from any litigation expense, legal fees, liability, damage, award or cost, of any form or type whatsoever, they may incur due to any claim made against them or any one of them by me or on my behalf, or that of my estate, whether the claim is based on the negligence or the gross negligence of the Releasees or otherwise as stated above.

5. AN AGREEMENT that this document be governed by the laws, and in the courts, of the Province in which the EVENT occurs.

I HAVE READ AND UNDERSTAND THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN SUBSTANTIAL LEGAL RIGHTS WHICH I AND MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS MAY HAVE AGAINST THE RELEASEES.

I SIGN THIS DOCUMENT VOLUNTARILY AND WITHOUT INDUCEMENT

2024 Media Release

I understand and agree that media captured during an event for an interview or race footage will be used for promotional and public media purposes. I grant to the Producer, Flat Track Canada to all rights worldwide in perpetuity for all uses of interview/footage, in all media. I agree that my interview may be modified and edited in the Producer's or Directors sole discretion. I release the producer and its personnel, broadcasters and other licensees from all claims, which I may have resulting from any use of my interview or footage of me as, permitted by this Release.



First Member's Name

First Name*

Last Name*

Phone*
First Member's Date of Birth*
First Member's Information
Home Club*

Requested Rider Number:


1st choice *

2nd Choice

3rd Choice

Bike Make *

Model *

Classes *

Online BIO Info:



First Bike Owned:

Favourite Track:

Hometown:

When did you start racing and why?

Career Highlights:

Goals for next season:

I agree to sign that I have read and understand the Insurance Waiver. I also agree and understand the promotional policy.

First Member's Signature*
Second Member's Name

First Name*

Last Name*
Second Member's Date of Birth*
Second Member's Information
Home Club*

Requested Rider Number:


1st choice *

2nd Choice

3rd Choice

Bike Make *

Model *

Classes *

Online BIO Info:



First Bike Owned:

Favourite Track:

Hometown:

When did you start racing and why?

Career Highlights:

Goals for next season:

I agree to sign that I have read and understand the Insurance Waiver. I also agree and understand the promotional policy.

Third Member's Name

First Name*

Last Name*
Third Member's Date of Birth*
Third Member's Information
Home Club*

Requested Rider Number:


1st choice *

2nd Choice

3rd Choice

Bike Make *

Model *

Classes *

Online BIO Info:



First Bike Owned:

Favourite Track:

Hometown:

When did you start racing and why?

Career Highlights:

Goals for next season:

I agree to sign that I have read and understand the Insurance Waiver. I also agree and understand the promotional policy.

Fourth Member's Name

First Name*

Last Name*
Fourth Member's Date of Birth*
Fourth Member's Information
Home Club*

Requested Rider Number:


1st choice *

2nd Choice

3rd Choice

Bike Make *

Model *

Classes *

Online BIO Info:



First Bike Owned:

Favourite Track:

Hometown:

When did you start racing and why?

Career Highlights:

Goals for next season:

I agree to sign that I have read and understand the Insurance Waiver. I also agree and understand the promotional policy.

Fifth Member's Name

First Name*

Last Name*
Fifth Member's Date of Birth*
Fifth Member's Information
Home Club*

Requested Rider Number:


1st choice *

2nd Choice

3rd Choice

Bike Make *

Model *

Classes *

Online BIO Info:



First Bike Owned:

Favourite Track:

Hometown:

When did you start racing and why?

Career Highlights:

Goals for next season:

I agree to sign that I have read and understand the Insurance Waiver. I also agree and understand the promotional policy.

Sixth Member's Name

First Name*

Last Name*
Sixth Member's Date of Birth*
Sixth Member's Information
Home Club*

Requested Rider Number:


1st choice *

2nd Choice

3rd Choice

Bike Make *

Model *

Classes *

Online BIO Info:



First Bike Owned:

Favourite Track:

Hometown:

When did you start racing and why?

Career Highlights:

Goals for next season:

I agree to sign that I have read and understand the Insurance Waiver. I also agree and understand the promotional policy.

Seventh Member's Name

First Name*

Last Name*
Seventh Member's Date of Birth*
Seventh Member's Information
Home Club*

Requested Rider Number:


1st choice *

2nd Choice

3rd Choice

Bike Make *

Model *

Classes *

Online BIO Info:



First Bike Owned:

Favourite Track:

Hometown:

When did you start racing and why?

Career Highlights:

Goals for next season:

I agree to sign that I have read and understand the Insurance Waiver. I also agree and understand the promotional policy.

Eighth Member's Name

First Name*

Last Name*
Eighth Member's Date of Birth*
Eighth Member's Information
Home Club*

Requested Rider Number:


1st choice *

2nd Choice

3rd Choice

Bike Make *

Model *

Classes *

Online BIO Info:



First Bike Owned:

Favourite Track:

Hometown:

When did you start racing and why?

Career Highlights:

Goals for next season:

I agree to sign that I have read and understand the Insurance Waiver. I also agree and understand the promotional policy.

Ninth Member's Name

First Name*

Last Name*
Ninth Member's Date of Birth*
Ninth Member's Information
Home Club*

Requested Rider Number:


1st choice *

2nd Choice

3rd Choice

Bike Make *

Model *

Classes *

Online BIO Info:



First Bike Owned:

Favourite Track:

Hometown:

When did you start racing and why?

Career Highlights:

Goals for next season:

I agree to sign that I have read and understand the Insurance Waiver. I also agree and understand the promotional policy.

Tenth Member's Name

First Name*

Last Name*
Tenth Member's Date of Birth*
Tenth Member's Information
Home Club*

Requested Rider Number:


1st choice *

2nd Choice

3rd Choice

Bike Make *

Model *

Classes *

Online BIO Info:



First Bike Owned:

Favourite Track:

Hometown:

When did you start racing and why?

Career Highlights:

Goals for next season:

I agree to sign that I have read and understand the Insurance Waiver. I also agree and understand the promotional policy.

Member's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


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 Date of Birth*
Parent or Guardian's Information
Home Club*

Requested Rider Number:


1st choice *

2nd Choice

3rd Choice

Bike Make *

Model *

Classes *

Online BIO Info:



First Bike Owned:

Favourite Track:

Hometown:

When did you start racing and why?

Career Highlights:

Goals for next season:

I agree to sign that I have read and understand the Insurance Waiver. I also agree and understand the promotional policy.

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.


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