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Waiver of Liability
POKER RUN & CAR SHOW WAIVER OF LIABILITY
IN CONSIDERATION for being permitted to participate in the
Event and Poker Run, sponsored by the Boys & Girls Club of Bloomfield THE
UNDERSIGNED PARTICIPANTS:
1. HEREBY RELEASE, WAIVE, ABSOLVE, INDEMNIFY, DISCHARGE AND AGREE TO HOLD
HARMLESS the Boys & Girls Clubs of America, Boys & Girls Club of
Bloomfield, NM, their employees, Board of Directors, organizers, sponsors,
volunteers, officers and members, along with any other event affiliated persons
and all of its holdings, and owners and lessees of premises used to conduct the
event/ poker run and each of them, their officers and employees, the dealers,
officers, directors, management, officials and volunteers assisting in the
event/ poker run, the sanctioning organization or any subdivision thereof, partner
businesses, grounds operators, grounds owners, officials, promoters, sponsors,
advertisers; all for the purpose herein referred to as “releases,” from all
liability to the undersigned, their personal representatives, assigns, heirs,
and next of kin for any and all loss or damage, and any claim or demands
therefore on account of injury to the person or property or resulting in injury
or death of the undersigned, whether caused by the negligence of the releases
or otherwise while the undersigned is participating in the event;
2. HEREBY AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS the releasees and each
of them from any loss, liability, damage, or cost (including attorney’s fees)
they may incur due to the presence of the undersigned participating in the
event and whether caused by the negligence of the releases or otherwise.
3. THE UNDERSIGNED PARTICIPANTS agree that while participating in this event,
the use of alcohol or any substance which affects the ability to operate or
control his or her vehicle or may be considered as hazardous to the health and
safety of participants and spectators is strictly forbidden.
4. THE UNDERSIGNED AGREES that he or she will not use or operate any vehicle in
violation or contravention of any City, County, State or Federal laws, statutes,
ordinances or regulations and shall be personally liable for all fines and
penalties for traffic law violations.
5. HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH AND/OR
PROPERTY DAMAGE due to the negligence of releases or otherwise while
participating in the event.
EACH OF THE UNDERSIGNED expressly acknowledges and agrees that the foregoing
release, waiver, and indemnity agreement is intended to be as broad and
inclusive as is permitted by law of the State in which it is operated in and
that if any portion thereof is held invalid, it is agreed that the balance
shall, notwithstanding, continue in full legal force and effect.
THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE RELEASE AND WAIVER OF
LIABILITY AND INDEMNITY AGREEMENT, and further agree that no oral
representations, statements or inducements apart from the foregoing written
agreement have been made.
I understand and accept that in the course of my attendance at and
participation in the Event/ Poker Run; Film and/or Photographs may be taken, or
illustration may be made of me and/or my personal property (including, but not
limited to my Vehicle, Motorcycle, Etc.). I acknowledge and agree that such
film/photographs and/or illustrations may be used in any medium by the Boys
& Girls Club of Bloomfield, NM and all its related entities and agencies
for advertising, fundraising and promotional purposes in any medium, without
compensation to me.
PLEASE PRINT LEGIBLY
NAME: _______________________________________________________________
ADDRESS: _____________________________________________________________
CITY/ STATE/ ZIP: _______________________________________________________
PHONE: __________________________ EMAIL: ______________________________
SIGNATURE: _______________________________ DATE:______________________
*How did you hear about our event?
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