Great Lake Chase Road Rally Agreement and Release
Liability Waiver, Personal Injury Disclaimer & Photo Release
*All participants, passe ngers, spectators and worke rs must sign t his wai ve r.
*DRIVERS MUST BE AT LEAST 18 YEARS OF AG E.
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I am attending the Great Lake Chase Road Rally as a driver participant, passenger, spectator or worker
for fun and recreation. I agree to follow the directions of the Great Lake Chase Road Rally officials.
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I agree that I willingly accept the risk of driving on the stretch of road that makes up the rally site,
knowing that it may be dangerous. I understand that I am responsible and accept the liability for my
safety and the safety of any passengers that I take in my car during the event. I understand that there is
a possibility that I and/or my guest(s) could be injured or killed at the event.
·
I understand that I am the only person responsible for the safety of myself and my vehicle. I recognize
and assume all risk of damage, injury and death that may be caused by a failure of any component of
the vehicle. I am responsible for ensuring that my vehicle is in safe operating condition before the
event.
·
I hereby release LIFESPAN Incorporated (“LIFESPAN”), the Great Lake Chase Road Rally, the State of
North Carolina, their officials, officers, members, workers, sponsors, spokespersons and other
participants (collectively, the “Great Lake Chase Road Rally Crew”) against all suits, claims or losses,
including costs, expenses and attorneys’ fees incurred as a result of any act or omission, neglect or
misconduct of the Great Lake Chase Road Rally or the participants during the event. Likewise, I
release the Great Lake Chase Road Rally Crew from any liability or damage to my car or equipment,
theft of the same, injury or death of myself and anyone accompanying me at the event, which may
result from my participation in this event.
·
I understand that the use of alcohol or illegal drugs by me or my guest(s) will subject us to immediate
dismissal from the event.
·
I certify that I am physically fit to participate in this driving event. I am not suffering from any diseases or
disorders or under any drugs, legal or illegal, that would affect my performance during the event.
·
I give the right to medical personnel to treat me for medical conditions that might occur while attending
the Great Lake Chase Road Rally.
In addition to releasing LIFESPAN from liability due to injury, I grant full permission for LIFESPAN to use
photographs, film or videotape of me or my likeness for reasonable, legitimate and lawful business purposes.
Print Name:
Date:
Signature:
Signature of Parent or Guardian (if under the age of 18):