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REGISTRATION / WAIVER FORM

MOTORCYCLE RUN WAIVER, RELEASE & HOLD HARMLESS FORM

By signing this waiver, I acknowledge that I am fully aware of the danger(s) and

hazard(s) associated with participating in a motorcycle ride. I certify that I am duly

licensed and competent to operate a motorcycle in a safe and responsible manner, and the

vehicle is in safe operational condition. I will be riding on public highways and

understand that I am solely responsible to determine the speed and operational

characteristics of my motorcycle while participating in the run. I hereby release and hold

harmless New Bern VFW Post 2514 and any of its members, against any and all claims,

causes of action, and/or any other liability of any kind arising from my participation and

activity affiliated with this specific ride.

I agree to hold harmless those establishments affiliated with this run, during this run, and

accept full and sole responsibility for my own actions.

I certify that I have no known physical or mental impairment that may affect my safety or

the safety of other participants. I understand and acknowledge that the choice of wearing

a helmet and/or other protective gear is solely my choice and I am responsible for my

compliance with all state laws, including those regarding helmets. I certify that I am not

under the influence of any narcotic, alcohol or other substance that may impair my

understanding or judgment and that I will not at any time during this ride operate my

motorcycle under the influence of any narcotic, alcohol or other substance that may

impair me. I also understand that this Waiver and Release is in force from the date of

signature through September 17th, 2016 and covers any and all activities affiliated with

New Bern VFW Post 2514 and/or this run.

Driver’s Name (Printed)____________________________________________________

Driver’s Signature and Date_________________________________________________

Driver’s Address ___________________________________________________

____________________________________________________

Driver’s Phone Number_________________________________________

Driver’s E-Mail Address___________________________________________________

Rider’s Name (Printed) ____________________________________________________

Rider’s Signature and Date ________________________________________________

MUST BE PRESENT FOR DOOR PRIZES!!!!!

New Bern VFW Post 2514

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