
Address:__________________________________________________________________
City:_________________________State:_______________________Zip:______________
Phone:________________________Fax:________________Email:____________________________________________________________
Desired Camp:__________________ Dates:____________________________________
RidingExperience:_________________________________________________________
_________________________________________________________________________
You can mail, fax or email this form to American Supercamp. Your acceptance into the desired camp will not be guaranteed unless you submit a 50% deposit. Faxing or emailing this form to American Supercamp will hold your spot for 48 hours until your deposit of 50% has been received or you have contacted American Supercamp regarding payment.
VISA ___ MASTER CARD ___
I (PLEASE PRINT)________________________________
hereby release Danny Walker, Chris Carr and the American Supercamp personnel,
independent contractors, agents, assignees (hereinafter referred to as "Released
Parties") for any and all injuries suffered by me at said camp sessions
and traveling to and from same or while participating in any camp activities.
I am aware of the inherent hazards of motorcycle riding. Further, I understand
that motorcycle riding or racing and all camp activities involve certain
risks: impact with other students or instructors, natural and man made obstacles.
I understand that crashing is necessary for training and involve the same
risks, I understand that the "Released Parties" may not be held
liable or responsible in any way for any injury, death or other damages
to me that may occur as a result of my participation in the American Supercamp
or as a result of negligence of any party, including the "Released
Parties", whether passive or active. I authorize the American Supercamp
Staff to act for me according to their best judgement in any emergency requiring
medical attention. I understand that the deposit of 50% per session attending
is non-refundable.