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Opotiki Blue Light Trolley Derby

Participants Declaration
In return for Opotiki Bluelight permitting myself or dependant to participate in Opotiki Trolley Derby we agree that:
1. That we have read and understood the Rules of the Trolley Derby, and agree to be bound by them including any modifications subsequently advised prior to the race
2. That participating in the Trolley Derby might cause serious injury, damage to property, cause trauma to friends and family spectating.
3. That we participate in the Trolley Derby entirely at our own risk.
4. That we will not make any claim against organisers, sponsors or its agents for any injury in connection with our participating in the Trolley Derby, regardless of how the injury, damage, or loss or expense occurs whether through negligence of organisers, sponsors or their agents.
5. That we shall advise the organisers of any existing medical condition that may affect us and consent to receiving any medical attention which organisers or its officials deem necessary in the circumstances.
6. That any photos and videos taken of us together with our names may be used by Opotiki Bluelight
7. That we indemnify event organisers, sponsors and their agents against all claims, damages, losses or expenses which they may incur as the direct or indirect result of any injury, damage to any property, trauma to friends and family.
8. That we are aware of and understand the Trolley Derby rules in relation to late entries and no refunds.
9. We acknowledge that the Trolley Derby judges decision shall be final.
I agree to the above conditions.
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Race Representative's Signature | |
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Signature: |
* write your name in this field before Submitting to indicate that you understand and accept our terms and conditions. |
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Date: |
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Year 4 and under
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Years 5 & 6
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Years 7 & 8
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Years 9 & 10
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Years 11 - 14
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and Open Class
| Phone: | 07 315 1117 Ian Dodds |
| Address: | Gows Road, Opotiki |
| Email: | ian.dodds@police.govt.nz |
| Website: | view a video at www.youtube.com |
| Cost: | School Age $5 - Adults $10 |
| Date: | 30th October 2010 |










