REGISTRATION FORM


TEAM NAME

    
PLEASE INCLUDE MY TEAM AS PART OF THE KGO SUPER TEAM. We will join (check one):
                    



TEAM REGISTRATION FEE:  $181 donation to JSHOFNC.
Additional pledges count towards priority seating in the competition.

All bed racers MUST sign the Waiver of Liability and acknowledgement of the Bed Race Rules
before participating in the race.  Team members must be at least of 16 years of age.

RACE TEAM WAIVER OF LIABILITY & INDEMNITY
AND RELEASE FOR RADIO, TELEVISION AND PRINT MEDIA




BED RACE FOR THE FUTURE WAIVER OF LIABILITY

I know that participating in a Bed Race is a potentially hazardous activity.  I assume the risk of participating in this race.  I also assume any and all other risks associated with this event, including but not limited to falls, contact with other participants, spectators or equipment, the affects of weather, including hear and/or humidity, and the conditions of the roads, all such risks being known and appreciated by me.  In consideration of your permitting me to participate in the Bed Race for the Future on April 17, 2010, I hereby for myself, my heirs, executors, administrators or anyone else who might claim on my behalf, covenant not to sue, and waive, release and discharge the Bed Race for the Future, its members, volunteers, race officials and any sponsoring body or organization, their successors and assigns, and the State of California, City and County of San Francisco, The Jewish Sports Hall of Fame of Northern California,  NFL Alumni, The Sleep Train, Inc., Infineon Raceways, KGO Radio, and their respective officials, from any and all claims or cause of action I may have caused or have been responsible for including, without limitation, personal injuries, property damages or other claims arising out of the Bed Race for the Future and/or any of that events related activities. I also agree to abide within the rules and regulations issued by race officials.

INDEMNITY AND RELEASE FOR RADIO, TELEVISION AND PRINT MEDIA

For sufficient consideration and the right to appear, I agree to protect and indemnify the Bed Race for the Future, its members, volunteers, race officials and advertising agent(s), their respective officers and employees, and to hold it, and them harmless from and against liability, loss, damages, expenses, judgments, counsel fees, costs and other charges, against or them or for which it or they shall become liable by virtue of or arising out of or caused by any matter or materials supplied or spoken by me in the telecast of the Bed Race for the Future to use my picture and/or name in any publicity deemed necessary for the promotion of this event, or other organization events, at no compensation.




SITTER NAME
PUSHER NAME 1
PUSHER NAME 2
PUSHER NAME 3
PUSHER NAME 4
ALTERNATE NAME

Click here to submit form and to advance to purchase:
    DOB
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The deadline for submitting this form is Thursday, April 15, 2010.
CONTACT: JSHOFNC, 4200 Indigo Oak Court, San Jose, CA 95121
408-374-1600 or email gary@jshofnc.org