5th Annual Pumpkin Run ATV Rally October 4-7, 2007
 
Print form and then sign & mail your registration along with fee of $8/person before September 17,  2007 or $10 after. 
Mercer Chamber of Commerce, 5150N Hwy 51, Mercer, WI 54547

Please circle one registration site-  Hurley or Mercer - where you plan to check-in.

PARTICIPANT AGREEMENT, RELEASE, AND ACKNOWLEDGEMENT OF RISK. In consideration of the services of the Mercer Area Chamber of Commerce Inc. and the Hurley Area Chamber of Commerce Inc., their agents, owners, officers, volunteers, participants, employees and all other persons or entities acting in capacity on their behalf ( hereinafter collectively referred to as Mercer Area Chamber of Commerce Inc. or the Hurley Area Chamber of Commerce Inc.) I hereby agree to release and discharge Mercer Area Chamber of Commerce Inc. and the Hurley Area Chamber of Commerce Inc., on behalf of myself, my children, my parents, my heirs, assigns, personal representative and estate as follows:

1.I acknowledge that certain known and unanticipated risks which could result in physical or emotional injury, paralysis, death or damage to myself, to property, or to third parties. I understand that such risks simply can not be eliminated without jeopardizing the essential qualities of the activity. The risks include among other things: Collision with other riders or objects along the trails, walls or other fixed objects : falling down: my own equipment failure or the failure of other’s equipment : my own or other’s negligence : objects or conditions on the surface that may cause me to fall : broken bones; sprains: head, neck and back injuries: abrasions: and bruises. Furthermore, employees and volunteers have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant’s fitness or abilities. They may give inadequate warnings or instructions and the equipment being used might malfunction.
2.I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate in spite of the risks.
3.I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless the Mercer Area Chamber of Commerce Inc. and the Hurley Area Chamber of Commerce Inc.from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of Mercer Area Chamber of Commerce’s or the Hurley Area Chamber of Commerce Inc.equipment or facilities, including such Claims which allege negligent acts or omissions of.
4.Should the Mercer Area Chamber of Commerce Inc or the Hurley Area Chamber of Commerce Inc. anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.
5.I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating. Or else, I agree to bear the costs of such injury or damage . I further certify that I have no medical or physical conditions, which could interfere with my safety in this activity. Or else, I am willing to assume and bear the costs of all risks that may be created, directly or indirectly, by any such condition.
6.In the event that I file a lawsuit against the Mercer Area Chamber of Commerce Inc. or the Hurley Area Chamber of Commerce Inc., I agree to do so solely in the state of Wisconsin. I further agree that the substantive law of that state shall apply in this action without regard to the conflict of law rules of that state.
7.I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portion shall remain in full force and effect.
By signing this document, I agree that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against the Mercer Area Chamber of Commerce, Inc. and the Hurley Area Chamber of Commerce Inc. on the basis of any claim from which I have released them herein.I have had sufficient opportunity to read this entire document. I have read and understood it, and agree to be bound by its terms.

Signature of participant_________________________________________________________________________

Print Name___________________________________________________________________________________

Address___________________________________________________City________________________________ 

State________ Zip Code_______________  Phone: ( ) _______________________ Date_________________

PARENT’S OR GUARDIAN’S ADDITIONAL INDEMNIFICATION
(Must be completed for participants under the age of 18)

IN consideration of _______________________________________________(Print Minor’s name) being

permitted by __________________________________________________(Print Parent or Guardian’s name)

to participate in its activities and to use its equipment and facilities. I further agree to indemnify and hold harmless the Mercer Area Chamber of Commerce, Inc. and the Hurley Area Chamber of Commerce Inc.,from any and all Claims which are brought by, or on behalf of the said Minor, and which are in any way connected with such use or participation by the said Minor.
Parent or Guardian Signature___________________________________________________Date:____________


Mercer, Wisconsin, home of great fishing, snowmobiling, cross country skiing, lodging in hotels, motels, cabins and resorts.  Also home of the Turtle Flambeau Flowage and it's fishing, boating, canoeing, kayaking and wilderness camping opportunities.

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