ATV Speed Pit and Mud Bog

Registration Form


Please print clearly:

Name: _________________________________        Age: _____________

Address: __________________________________________________

City: ______________________                State: _______        Zip: _________

Phone: ___________

Year: ________   Make: ________________        Engine: __________

2 or 4 Wheel Drive: _________

Sponsor(s): ________________________________________________

Comments: ________________________________________________




Waiver

I hereby release and agree to hold harmless the fair promoters, owners, employees, or other participants, or anyone
from any and all liabilities that may occur to my person or my property in any way resulting from or in connection with
this event while on the premises.  I know the risk and I assume all responsibility whatsoever.

Rider’s Signature: ___________________________________        Date: ___________

Parent or Guardian Signature (if rider is under 18): __________________________