Minor Release and Waiver of Liability and Indemnity Agreement |
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_KAM Kartway_________________________Rhome,
Tx______________All KAM Kartway Events for the Year 2008__________
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2. I/we fully understand
and acknowledge that: 3. I/we accept and assume such risks and responsibility for the losses and/or damages following such injury, disability, paralysis or death, however caused and whether caused in whole part by the negligence of the "Releasees" named below. 4. I/we HEREBY RELEASE, WAIVE, DISCHARGED AND COVENANT NOT TO SUE the promoter, participants, racing associations, sanctioning organizer or any subdivision there of, track operator, track owner, officials, car owners, drivers, pit crews, any persons in any restricted area, promoters, sponsors, advertisers, owners, lessees of premises used to conduct the event and each of them, their officers, agents and employees, all for the purpose herein referred as "Releasees," from all liability to the undersigned, my/our personal representatives, assigns, executers, heirs and next of kin for any and all claims, demands, losses or damages on account of any injury, including but not limited to the death of the participant or damage to property, caused or alleged to be cause in whole or in part by the negligence of the "Releasees" or otherwise. 5. On behalf of the participant and individually, the undersigned parent(s) and/or legal guardian(s) for the minor participant executes this Waiver and Release . If, despite this release, the participant makes a claim against any of the "Releasees," the parent(s) and/or legal guardian(s) will reimburse the "Releasees" and their insuring company for any money paid to the participant, or on his behalf, and hold them harmless. I/WE HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I/WE GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT VOLUNTARILY WITHOUT INDUCEMENT. |
| 1. I have read this release________________________________/____________________Date_______________ Parent or Guardian (Signature/Relationship) 2.I have read this release________________________________/____________________Date_______________ Parent or Guardian (Signature/Relationship) Printed Name of Participant:__________________________________________________ Address of Participant:______________________________________________________ Printed Name of Parent or Guardian:1.__________________________________________ Printed Name of Parent or Guardian:2.__________________________________________ __________________________________, ____________________________________ (LAST NAME) (minor child) (FIRST NAME) |
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CONSENT TO MEDICAL TREATMENT I,_____________________________, the (parent) (guardian) of______________________, a minor child whose birth date was____________,_____ and who is the child of ___________ |
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herby authorizes any duly authorized doctor, hospital or other medical
facility to treat minor on or after _______________ _______________for
the purpose of attempting to treat or relieve any injuries received by
said minor while he was a participant or observer at KAM Kartway. I authorize any licensed physician to perform any procedure which he deems advisable in attempting to treat or relieve any injuries or any unhealthy condition of said minor that he may encounter during any necessary operation. I consent to the administration of anesthesia as deemed by an licensed physician. I realize and appreciate that there is a possibility of complications and unforeseen circumstances in any medical treatment and I assume any such risk on the behalf of myself and said minor I acknowledge that no warranty is being made ad to the results of any treatment. ________________________________
_________________________________ Witness my hand and seal this__________________ day of_________________,_________.
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