That I, (Riders name)___________________________a minor in consideration of receiving permission from POWERSPORTZ INC,  to participate, when qualified either as a rider, mechanic, owner, attendant, or in any other capacity, in any race or practice held at the above mentioned premises, the receipt of such permission being also hereby acknowledged, each of the undersigned hereby released POWERSPORTZ INC., the promoter and its agents, officers, servants, and, employees, of and from any and all liability, claims, demands, actions, and causes of actions whatsoever, arising out of or related to any loss, damage or injury, including death, that may be sustained by any or each of the undersigned, or any property of any of each of the undersigned, while on, in, or upon the above mentioned premises, or any premises, leased or in route to or from the above mentioned premises, or any other premises leased to or under the control of supervision of POWERSPORTZ INC.

Each of the undersigned being fully aware of the risks and hazards inherent upon entering upon said premises and/or participating in any races or practices held at such premises, hereby elects voluntarily to enter upon said premises, knowing their present conditions and knowing that said conditions may become more hazardous and dangerous during the time that each  of the undersigned is upon the said premises.  Each of the undersigned hereby voluntarily assumes all risks of loss, damage, or injury, including death, that may be sustained by any or each of the undersigned, or any property of any of each of the undersigned while in, on or upon the said premises.

This release shall be binding upon the distributees, heirs, next of kin and personal representatives of each of the undersigned.

In signing the foregoing Release, the undersigned hereby acknowledges and represents:

1. That he/she has read the foregoing Release, understands it, and signs it voluntarily;
2. That the undersigned parent(s)/guardian(s), is over twenty-one (21) years of age and of sound mind;
3. That the undersigned minor, is racing or participating on the above mentioned premises with the knowledge and consent of the parent(s)/guardians(s);
4. That he/she is not an agent, servant, or employee of POWERSPORTZ INC, and/or any of the agents, officers, servants, or employees of the promoter.

The undersigned parent(s)/guardian(s) further for said conditions hereby agrees to protect POWERSPORTZ INC, its personal representatives and assigns any actions, claims or demands by said minor, or by any other persons on account of damages of any character resulting in any way from said racing or practicing on the above mentioned premises by said minor, and we also hereby agree to reimburse and make good to POWERSPORTZ INC, and loss, damages, or costs it may have to pay as a result of such action, claims or demands.

IN WITNESS WHEREOF, the undersigned has hereunto set his/her hand and seal this
_________________day of _______________________2007.

DRIVERS LIC.#__________________________________ 
NOTARY PUBLIC____________________________

MINOR NAME_________________________________   
MINOR SIGNATURE__________________________
____________________________________________
PARENT/GUARDIAN
____________________________________________
PARENT/GUARDIAN SIGNATURE

EMERGENCY PHONE (____) _____________________   

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