Rt. 66 Freedom Ride, Flight & Cruise

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ROUTE 66 FREEDOM RIDE & FLIGHT

REGISTRATION & LIABILITY RELEASE FORM

 

In consideration of the acceptance of my application for entry in the Route 66 Freedom Ride & Flight motorcycle Ride on July 28/29/30, 2017.  I/we hereby waive, release and discharge any and all claims for damages or death, personal injury or property damage which I may have, or which may hereafter accrue to me, as a result of my participation in said event.  This release is intended to discharge in advance the promoters of the Route 66 Freedom Ride & Flight motorcycle Ride, City of Gallup, Gallup-McKinley County Chamber of Commerce, as well as, any sponsors or affiliated organizations from and against any and all liability arising out of, or connected in any way with my participation in said event, even though that liability may arise due to negligence or carelessness on the part of the persons or entities mentioned above

     I further understand that serious accidents occasionally occur during motorcycle riding; those participants in motorcycle riding and runs occasionally suffer mortal or serious personal injuries and/or property damage as a consequence thereof.  Knowing the risks of motorcycle riding, nevertheless, I hereby agree to assume those risks and to release and hold harmless all of the persons or entities mentioned above whom through negligence or carelessness might otherwise be liable to me or my heirs and assigns.

     I further agree to obey all motor vehicle laws while participating in the event, including those pertaining to drinking while operating a motor vehicle.

 

Name (Print):  _________________________________________ Date:____________________

 

Address:________________________________City:________________State:______Zip:_____

 

Email:________________________________________________________________________

 

Telephone:_____________________________________Cell:____________________________

 

Signature of Entrant:  ____________________________________________________________

 

Passenger Name (Print):  _____________________________________ Date:_______________

 

Signature of Passenger:  __________________________________________________________

 

Amount Paid:__________  Pre-register: Yes    No      Method: Email    Website   Gallup Chamber

 

Payment method: Cash_____ Check_____ Money Order_____ Credit Card_____

 

Starting Location: Glenrio ______ Santa Rosa ______ Moriarty______ Grants______

 

 

                                                                                                      Initial:_______