NOTE: All minors must fill out a Parental Consent Form and the Medical Consent form . No one under the age of 16 may attend this event. For a printable version of this document in Word format, please use this Registration Form . Prices: For re-enactors$30 until December 26th, $35 after Dec. 26th at gate For re-enactor / vendors $35 until December 26th, $40 after Dec. 26th For vendors only $40 |
| REGISTRATION FORM Liri Valley Campaign -Auruno Mountains Italy WWII Tactical Battle Event January 11- 13, 2008 Ocala, Florida Presented by Hard Rock Cycle Park Waiver for Liability 1. Assumption of Risk. I, the undersigned, do hereby acknowledge that as a participant in the WWII reenactment event, I freely and voluntarily engage in a hazardous activity for my own recreation and enjoyment. I recognize that as a part of this activity other participants and I will traverse difficult and dangerous terrain and obstacles, and that I and others around me will use various firearms and weapons, explosive materials and devices, and I will ride in hazardous transportation, and that I freely and voluntarily assume any and all risk of injury associated with these activities. For these reasons, I hereby waive and release from liability and agree to hold harmless the following: Hard Rock Cycle Park (HRCP), or the staff or personnel or volunteers of the above and all owners and operators of participating vehicles, both modern and period, that may be used to transport or move personnel at the event. Although facilities, refreshments, and other assistance may be made available during this event, I am responsible for my own health and safety. . I represent and warrant that I am in good health, physically fit to engage in this activity, and have no medical condition that would possibly jeopardize my safety during such participation or be aggravated by such participation. I agree to stop and request assistance if I experience any symptom such as, but not limited to, dizziness, excessive fatigue, and shortness of breath, pain or any other conditions that would make it difficult or unsafe to continue. 2. Release from Liability. In consideration for my being allowed to participate in this event, I agree to exempt and release forever all personnel, officers, members of the Hard Rock Cycle Park (HRCP) and the event coordinators, event volunteers, and registered re-enactors from any liability, claims, demands or actions, or causes of action whatsoever arising out of any damage, loss, or injury to me or my personal property arising out of my participation in this event, whether such loss, damage, or injury results from the negligence of the HRCP, their personnel, officers, members or agents, or from some other cause. I also agree to exempt and release forever the Hard Rock Cycle Park, its agents, officers, and employees and also the event coordinators, event volunteers, and registered re-enactors, whether acting officially or not, for any liability, claims, demands or actions, or causes of action whatsoever arising out of my damage, loss, or injury to me or my personal property raising of my participation in this event, whether such loss, damage or injury results from the negligence of Hard Rock Cycle Park, officers, agents, employees. 3. Indemnification. In consideration for my being allowed to participate in this event, I agree to hold harmless and indemnify the HRCP, its personnel, officers, members and agents and employees and also the event coordinators, event volunteers, and registered re-enactors, against any claim or suit (including any attorney's fees, costs, and expenses) arising out of my participation in this event. I certify that I am 18 years of age or older. I further state that by signing this document I have fully read and understand its contents, and that I am voluntarily waiving rights that may be granted to me by federal, state and local statutes, as well as the common law of the State of Florida and the United States of America. I also state that I have read the rules and regulations of this event, and I am accountable for my actions. I further understand that violations of these rules and regulations could result in my expulsion from this event. Finally, I state that I have read a copy of this liability release and have completed the waiver and have kept a copy for my own information. Signature ________________________________________________Date__________________ Address _________________________________________________ State _____Zip ______________ Unit _______________________________________________________ E-Mail ____________________________Tel#______________________ EMERGENCY CARE AUTHORIZATION I, the undersigned, authorize the organizers and planners of this Event and their agents to authorize medical treatment on my behalf should I sustain any injury or suffer any medical distress while participating in this event. I will carry an emergency information form in the right breast pocket of my jacket for their use if needed that will contain my emergency medical information. In signing this authorization of medical care, I hereby acknowledge that I have read the above and that a copy of this form has been offered to me. Signature ________________________________________ Date _____________________ ? Printed Name___________________________________________ Witness _______________________________________________ |
| PARTICIPATION FEE Re-enactors $30 until December 26, $35 after Dec. 26 at gate Re-enactor / vendors $35 until December 26th, $40 after Dec. 26 Vendors only $40 NOTE: All minors must submit the Parental Consent Form. No one under the age of 16 may attend this event. |
| Address For ATF Form 5320.20
Hard Rock Cycle Park 6849 NW Gainesville Rd. |
| Make checks payable to: Hard Rock Cycle Park
Send to: Scott Campbell 18707 Geraci Road Lutz, FL 33548 |