Coldenham Fire Company Poker Run
2008
Release of Liability Form

We have done everything possible to provide a safe and fun event for your amusement. It is your responsibility to comply with the laws of the State of New York and the various Counties and to act in a sane and sensible manner. We are not in control of, nor do we accept responsibility for, your actions or behavior before, during, or after this event. This event is limited to persons 18 years of age or older.
I (We) [please print your name(s)] __________________________________________________________________
accept full responsibility for my(our) actions and behavior. I(We) hold blameless the promoters of the Coldenham Fire Company Poker Run for anything that may happen to me(us) or because of me(us) not caused by their culpable negligence. It is my(our) intent to act as a responsible adult and to participate in the event in a safe and sane manner.
I (We) accept the above without reservation:
signed__________________________________________ date: ____________ 2008
signed__________________________________________ date: ____________ 2008

 Registration

NAME:______________________________________________________________
ADDRESS:___________________________________________________________
PHONE NUBMER:____________________________________________________
MAKE OF BIKE:________________________PLATE #:__________________
YEAR:________
NAME(S) OF ADDITIONAL RIDER(S):_____________________________
_____________________________________________________________________

Email Address:  coldenham_poker_run@yahoo.com