Maritime Barrel Racing Association

WAIVERANDRELEASEOFLIABILITY

InconsiderationofbeingallowedtoparticipateinanywayinaMaritimeBarrelRacingAssociationsanctioned event,andinparticulartheJackpot/Show beingknownasBridgewater MBRA.Pointed Jackpot, @ South Shore Exhibition Grounds, Bridgewater, NS – June 11 & 12, 2016.

aswellasanyandallactivitiesrelatedtosuchevent,theundersignedacknowledges,appreciatesandagreesthat

1. Theriskofinjuryfromtheactivitiesinvolvedinthistypeofeventissignificant,includingthepotentialfor permanentparalysisanddeath,andwhileparticularrules,equipmentandpersonaldisciplinemayreducethisrisk, theriskofseriousinjurydoesexistand

2. IKNOWINGLY ANDFREELYASSUMEALLSUCHRISKS,bothknownandunknown,EVENIFARISING FROMTHENEGLIGENCE OFTHERELEASEESorothers,andassumefullresponsibilityformyparticipation and

3. Iwillinglyagreetocomplywiththestatedandcustomarytermsandconditionsforparticipationin thisevent. If howeverIobserveanyunusualsignificanthazardduringmypresenceorparticipation,Iwillremovemyselffrom participationandbringsuchtotheattentionofthenearestofficialimmediatelyand

4. I, formyselfandonbehalfofmyheirs,assigns,personalrepresentativesand nextofkin,HEREBYRELEASE ANDHOLDHARMLESS theMaritimeBarrelRacingAssociation,theirofficers,officials,agentsand/or employees,otherparticipants,sponsoringagencies,sponsors,advertisers,and, ifapplicable,ownersandlessorsof premisesusedtoconducttheevent("Releasees"),WITHRESPECTTOANYANDALLINJURYDISABILITY, DEATH,orlossordamagetopersonorproperty,WHETHERCAUSEDBYTHENEGLIGENCEOFTHE RELEASEESOROTHERWISE.

5.Iagreetoabidebyallof therules,regulations,andpoliciesoftheMaritimeBarrelRacingAssociationwhile participatingatthisevent.

IHAVEREADTHISRELEASEOFLIABILITY ANDASSUMPTION OFRISKAGREEMENT,FULLY UNDERSTANDITSTERMS,UNDERSTAND THATIHAVEGIVENUPSUBSTANTIALRIGHTSBY SIGNINGITANDSIGNITFREELYANDVOLUNTARILY WITHOUTANYINDUCEMENT.

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PARTICAPANT’S SIGNATURE

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PRINT NAME

FORPARTICIPANTS OFMINORITY AGE (UNDERAGEATTHETIMEOFREGISTRATION)

ThisistocertifythatI,asparent/guardian withlegalresponsibilityforthisparticipant,doconsentandagreeto his/herreleaseasprovidedaboveofallReleasees,and,formyself,myheirs,assigns,andnextofkin,IreleaseandagreetoindemnifytheReleaseesfromanyandallliabilitiesincidenttomyminorchild’s involvementorparticipationintheseprogramsasprovidedabove,

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PARENT/GUARDIAN’S SIGNATURE EMERGENCY PHONE NUMBER

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PRINT NAMENAME OF MINOR (please print)