Eitzen Lions -- Rivers
& Bluff's Classic Tractors LLC Ride
Starting & Ending at Eitzen Fire Station
Saturday July 2nd, 2011
| Name: _________________________ Telephone: ________________ Cell: ________________ |
| Address: ___________________________ |
| City: __________________ State: _______ Zip: ___________ Email: _____________________ |
| Emergency Contact: ________________________ Phone #: _________________ |
| Tractor Information: Year: _________ Make: _______________ Model: _________________ |
| Desired Traveling Speed: 10-12 MPH _____ 15 MPH _____ (All tractors must go 10 MPH minimum) |
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In consideration of your acceptance of this entry, I hereby, for myself, my heirs, my executors, administrators, waive any and all rights and claims for damage I may have against individuals associated with this event, its agencies, representatives, successors and assigns, for any and all injuries suffered by me in said event. I attest and verify that I have full knowledge of the risks involved in this event and am physically able and sufficiently trained to participate in this event. I understand the Rivers & Bluff's Classic Tractors LLC committee reserves the right to limit the number of tractors involved in this ride. The Rivers & Bluff's Classic Tractors LLC committee reserves the right to refuse a participant entry into this event if committee
desires to do so. Please return app.to |