ENROLLMENT/CLAIM FORM
In consideration of being permitted to participate in the Suzuki Good Scholar Program ("Program") during the 2003 model year (Sept. 2002 through July 31,
2003) I (PRINT NAME), __________________________________________, for myself, my successors, heirs, and assigns, release and forever
discharge American Suzuki Motor Corporation ("ASMC") and its affiliates, agents, employees, servants, officers, and directors, and authorized Suzuki dealers
("related parties"), from all claims, actions, or judgements I may have or claim to have against ASMC and related parties. I agree that I am responsible for all
personal injuries, including death, and injuries to property, real or personal, caused by or arising out of my participation in the Program for the 2003 model year.
I further agree for myself, my successors, heirs, and assigns to indemnify and hold ASMC and related parties harmless from all claims and suits for personal
injuries, including death, and damages to property caused by my act or omission arising out of my participation in the Program for the 2003 model year, and
from all judgements recovered and from all expenses incurred in defending such claims or suits.
I further agree that, without compensation, my name, as well as any photographs, pictures, slides, or movies taken of me or made in connection with my
participation in the Program for the 2003 model year, or any reproduction of the same, may in any manner be used by ASMC, or by any person, corporation, or
association authorized by ASMC without compensation.
I understand that Section 1542 of the California Civil Code provides that a general release does not extend to claims which I do not know or suspect to exist in
my favor at the time of signing the release, which if I knew or suspected such claims, would have materially affected my willingness to sign the release.
I HEREBY WAIVE MY RIGHTS under Section 1542 of the California Civil Code and any similar law of any other state, and I acknowledge that this waiver is
an essential term of the General Release without which I would not have signed this General Release.
Applicant's signature, or signature of parent or guardian if applicant is under 21 years of age:
Signature___________________________________________________________________________________________
I understand that I must be the registered owner of a 2003 U.S. model year Suzuki RM60, RM65, RM85, RM100, RM125, or RM250 motorcycle, race in at least
five organized motocross races during the 2002/2003 school year, be a full time student and maintain a "B", 3.0, or 80% Grade Point Average (GPA) for the
school year to qualify for the Program and receive an award. The Good Scholar award form must be postmarked by July 31, 2003, to be eligible for participation.
I have read and understand the foregoing release.
Signature of Applicant_________________________________________________________________ Date________________
Signature of Parent or Guardian___________________________________________________________ Date________________
Applicant's Social Security Number_____________-__________-_____________ E-Mail Address______________________________
Applicant's Name (PRINT)_______________________________ Age_____Date of Birth_________ Phone #(______)______________
Street Address______________________________ Apt. #_____ City_____________________________State____ Zip_________
PLEASE TURN OVER TO COMPLETE APPLICATION
2003 MODEL YEAR MOTOCROSS
GOOD SCHOLAR AWARD
