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Team Scherb Flattrack School Riders Name: __________________________________ Age:______________ Address: _________________________________________________________ City: ________________________ State: ________________ Zip: __________ Email Address: ____________________________________________________ Phone Number: ___________________________________________________ Bike Brand: ______________ Size/CC: _________________ Bike # ___________ Class/Classes raced: ________________________________________________ School Date: Friday, March 12 2010; 9:00 – 3:00 Flattrack School Cost: $150.00 (Includes lunch, soft drinks, and water.) A $50.00 deposit is required. Please fill out this form and mail to: North Forty Cycle Park, 727 Kessler Blvd., Sherman, TX 75092 Or Call David Henry 903-815-9185 ***Signature Required Below*** Please read carefully and sign signifying complete understanding I hereby agree to conform and comply with the rules set forth by the “Team Scherb Flattrack School” and the “North Forty Cycle Park”. I further agree to hold harmless Team Scherb, North Forty Cycle Park and/or its staff for any loss, injury or death that may occur to myself or to my property resulting from participation in their contests or schools. This constitutes an expressed acknowledgement and voluntary assumption of risks associated with motocross riding/racing and while being on the property of North Forty Cycle Park. Signature: ___________________________________ Date: __________________________ FOR PARENTS OR GUARDIANS OF ALL RIDERS UNDER 18 YEARS OF AGE Being the legal parent/Guardian of the above named minor child, I hereby approve of and agree to the participation of __________________________________________________ In the Team Scherb Flattrack School. I agree to the release clause listed on this page completely and without reservation. Signature Parent/Guardian: ___________________________________________________
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