MASON COUNTY MOTOSPORTS
SPRING DEMOLITION DERBY

JUNE 13, 2009

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2009 Mason County Fair

Spring Demolition Derby Entry Form

Drivers Name:___________________________________________________

Address:_______________________________________________________

City, State, Zip___________________________________________________

Phone:________________________________________________________

Large Car_______________ Mini Car_______________

Car Make/Model:___________________________Car Number___________

Sponsors:_____________________________________________________

_____________________________________________________________

RELEASE:

In Consideration for being allowed to participate in the demolition derby at the Mason County Fairgrounds, the undersigned agrees to release, indemnify and hold harmless the Mason County Fair,  the Mason County Fair Board, their officers, agents or employees, any and all promoters and officials from any and all liability and damages in any way resulting from the undersigneds participation in said demmolition derby.

_____________________________________________________________

Participant

_____________________________________________________________

Witness

_____________________________________________________________

Date