|
Saturday, 12 April 2008 13:23 |
Mohican MTB 100 State Park and Forest
WAIVER AND LIABILITY RELEASEBring a signed copy to the race or mail to: Mohican MTB 100 c/o Ryan O'Dell, PO BOX 97, Butler, Ohio 44822 Questions: Email Ryan O'Dell at
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
or call (419) 989-0239
(Please print all information except signature to allow for more accurate records)
NAME:________________________________________________________
ADDRESS:_____________________________________________________
CITY:_________________________________________________________
STATE:___ ZIP__________ DATE_________
__MALE __FEMALE AGE____
E-MAIL ADDRESS_________________________________________
WAIVER
I, intending to be legally bound, hereby, for myself, my heirs, executors and administrators, voluntarily assume all risks of accident or injury and release and forever discharge the State of Ohio, Ohio Department of Natural Resources, and its employees, officers and agents, from any and all liability for personal injury or property damage of any kind sustained at Mohican State Park and/or Mohican Memorial State Forest during the Mohican MTB 100 event held on May 30, 2009 whether such personal injury or property damage is caused by negligence of the State of Ohio, Ohio Department of Natural Resources, or its employees, officers, or agents or otherwise.
I further covenant and agree to indemnify and hold harmless the State of Ohio, and the Ohio Department of Natural Resources, its employees, officers, and agents, from all loss and expense, including but not limited to, damages, legal expenses, and cost of defense, in any manner arising from my use of the State Park and/or State Forest.
| ______________________________________ | | _____________ | | Participant (signature) | | Date | | ______________________________________ | | _____________ | | Participant (name printed legibly) | | Date | | ______________________________________ | | _____________ | Parent or legal guardian (signature)
if participant in under 18 years of age | | Date | | ______________________________________ | | _____________ | | Parent or legal guardian (name printed) | | Date |
|
|
Last Updated ( Wednesday, 18 February 2009 17:58 )
|
Mohican 100 Waiver
