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RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT 

THIS WAIVER MUST BE SIGNED BY ALL PARTICIPANTS 

For a child under 18 years of age, both parents, the parent with legal custody, or the minor's legal guardian must sign this release form.

For participation in the Coal Mine Cruiser Classic (CMCC), the undersigned hereby agrees to release and hold harmless all sponsors, trail guides, workers, volunteers, and owners of both public and private land where the CMCC is held as well as the officers, directors, agents and employees of the Gotham City Land Cruisers. The above shall also be released from any negligent act or omission and shall also include any loss damage or cost incurred due to participation in this event. The participant shall understand and assume full responsibility and risk for any property damage, injury or death while participating in this event. In signing this release, each participant hereby agrees to the following:

(A) The owner/operator certifies that the participating vehicle has been inspected & that it is in good working order.
(B) That each participant has informed himself/herself about the event and the trails involved in the event.
(C) That he/she has read all the foregoing Releases and Waiver of Liability and Indemnity Agreement.
(D) Participants acknowledge that trail riding is hazardous, dangerous, and unpredictable.
(E) You grant to GCLC the right to use, in whole or in part, photographs or video footage taken of you as a result of your participation in CMCC.

Coal Mine Cruiser Classic Rules:

1. ABSOLUTELY NO ALCOHOL, DRUGS, CAMPFIRES, FIREWORKS OR FIREARMS ARE ALLOWED ON GCLC TRAILRIDES.
2. Equipment/Safety Requirements: Roll bar or factory hardtop, seatbelts for driver & all passengers, working regular and emergency brakes, spare tire, fire extinguisher, cb radio, hi-lift jack or equivalent.
3. Authorized agents of GCLC may disqualify any vehicle at any time for safety reasons.
4. CMCC is a family-oriented event. Participants are expected to conduct themselves accordingly.

Any violation of these rules may result in expulsion from the event and forfeiture of all entry fees. 

I, the undersigned, have read and understand the above and agree to abide by same.

Today's Date: October 21, 2019

 

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

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

Email*

Confirm Email*
Check to receive information and news by e-mail.
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
Vehicle Information

Participating Vehicle Make, Model and Year *

License Plate Number

Driver Name

Passenger Name(s)

Vehicle Owner (if not driver)
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.
Parent or Guardian's Name

First Name*

Last Name*
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.


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