www.lebanonvalley.com • www.dragway.com Phone:
518-794-7130 Fax: 518-794-7889 SEBELL1862@aol.com
VEHICLE PARKING REGISTRATION FORM
PARKING RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT
1. Use of Property on the Premises. Use of the Property and the Premises by the Owner/Operator shall be in a proper and safe manner and
only for the specific purposes, manner of use, and other SUCH CONSIDERATIONS FOR WHICH SAID Property is rated and/or designated
and for no other purpose, in compliance with all statutes, ordinances, regulations, safety programs and other rules applicable to
the use thereof. The Owner/Operator shall not permit any crew member, employee and/or agent of the Owner/Operator to violate the covenants
or obligations of the Owner/Operator hereunder and Owner/Operator shall be and agrees to be responsible for any and all such violations.
2. Security/Risk of Loss. The Owner/Operator acknowledges that
3. Indemnification/Insurance. The Owner/Operator agrees to indemnify and save
4. Other Rules and Regulations:
A. The usage of the designated space shall be subject at all times to the
discretion of
B. The Owner/Operator
shall remove all property during designated events and park in the designated areas as stipulated by
C. All vehicles, trailers, etc.
shall be appropriately marked with competition numbers in the manner designed by
D.Only
E. Failure to comply with terms hereof or any other rule or regulation promulgated by
5. Miscellaneous: Lebanon Valley as used herein shall include any promoters, racing associations, sanctioning organizations, track operators,
track owners, officials, personnel, sponsors, advertisers, owners and lessees of the Premises, underwriters, insurance carriers, consultants,
their directors, officers agents and employees. All representative, covenants, indemnification’s and obligations of the Owner/Operator
shall survive any manner of termination of this Agreement by its terms or otherwise.
Owner/Operator HEREBY ACKNOWLEDGES THAT
THIS IS A LEGALLY BINDING WAIVER OF LIABILITY, ASSUMPTION OF RICH AND IMNEMNIFITY AGREEMENT, FULLY UNDERSTANDS ITS TERMS, UNDERSTANDS
THAT HER/SHE HAS GIVEN UP SUBSTATIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE,
OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST
EXTENT ALLOWABLE BY LAW.
OWNER/OPERATOR
(Print Name Here)
(Signature)
(Address)
__________________________________ ________________________________ ____________________________
(City) (State) (Zip Code)
Home Phone: (_________) ________________________ Cell Phone: (_________)
_____________________________________
In the event we cannot contact you, please list an emergency contact :
Name: __________________________________________ Phone: ____________________________________________________
Race Car # ____________________ Class:_____________________________________
Trailer License Plate # ______________ State: _______ Make/Model: ___________ Color of Vehicle:_____________________
Tow
Vehicle/Motorhome Plate#________________ State:____________
Make Model of Tow Vehicle: ___________________________ Color of Vehicle: _________________________
____________________________________OFFICIAL USE ONLY_____________________________________
Registration
# ________________________________
Assigned Area ________________________________
Date Received: __________________________________________ By: ________________________________________