HEROES HIGHWAY RIDE & RALLY Registration Please Print Clearly Riders Name: __________________________________________ Passengers Name: _______________________________________ Address: _______________________________________________ City: ______________________________ Province/State: _______ Postal Code: ____________ Phone: _________________________ E-Mail: ________________________________________________ License Plate #: _____________________ Province/State: _______ Waiver WAIVER IN CONSIDERATION of acceptance of my application and the permission to participate as an entrant in the Heroes Highway Ride. I, myself, my heirs, executors, administrators, successors, assigns, assumes all risks and dangers and DO HEREBY RELEASE, WAIVE AND FOREVER DISCHARGE Lou DeVuono, the Board of Directors of the Heroes Highway Ride & Rally Association, the Perfect Pigs M.C., the Ministry of Defence, Canadian Forces Base Trenton, the Province of Ontario, the participating Municipalities, Ontario Provincial Police, local police forces (regular and auxiliary), the Commissioner and Chiefs of Police, other Associations, local charities, volunteers, sanctioning bodies and sponsoring companies and all of their respective agents, officials, officers, directors, partners, employees, shareholders, association members, servants, contractors, representatives, elected and appointed officials, successors, assigns, heirs, executors, and administrators where applicable OF AND FROM ALL claims, demands, damages, costs, expenses, actions, causes of actions, suits, depts.., duties, accounts, bonds, warranties, indemnities, claims over, contract and liabilities, whether in law or equity, in respect of death, injury, loss or damage to my person or property HOWSOEVER CAUSED, arising or which may arise by reason of my participation in said event, whether AND NOTWITHSTANDING that the same may have been caused by or contributed to or occasioned by negligence of the aforesaid. I FURTHER UNDERTAKE to HOLD AND SAVE HARMLESS AND AGREE TO INDEMNIFY all of the aforesaid from and against any and all liability incurred by any or all of them arising as a result of, or in any way connected with my participation in the said event. BY SUBMITTING THIS ENTRY, I ACKNOWLEDGE HAVING READ, UNDERSTOOD AND AGREED to the above WAIVER, RELEASE AND INDEMNITY. I WARRANT that I am physically fit to participate in this event and that I am 18 years of age or older and currently hold a valid license and valid vehicle insurance as required by Ontario law. Photo/Video Release I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on video, digital camera and/or other electronic means without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published or distributed and hereby waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image and/or recording. Additionally, by signing this release I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet and/or in a public setting. By signing this form I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material. Riders Signature: _____________________________________ Date: _________________ Passengers Signature or Guardian (if applicable): ________________________________ |
