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Suzuki - frm mx (Page 1)

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Suzuki - frm mx
In consideration of being permitted to participate in the Suzuki Contingency Program during the 2000 season, 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, directors, and authorized SUZUKI
dealers ("related parties") from all claims, actions, or judgements I may have or claim to have against ASMC and related par-
ties. 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 Suzuki Contingency Program for 2000.
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 Suzuki Contingency Program for 2000, and from all judgements recovered and from all expenses
incurred in defending said claims or suits.
I further agree that without compensation, my name, as well as any photographs, pictures, slides, or movies taken of myself or
made in connection with my participation in the Suzuki Contingency Program for 2000, or any reproduction of the same, may
in any manner be used by ASMC, or by any person, corporation or association authorized by ASMC.
I am in good health and have no physical conditions that would prevent me from participating in road racing events.
I understand that contingency payments will not be made to classes that have fewer than five (5) riders. Only 1999 and 2000
U.S. RM models are eligible for motocross contingency. Racers must own the motorcycles raced in the contingency races in
order to receive payment. I agree to include proof of ownership*. I agree to complete this contingency application and submit
it to ASMC within 30 days of my first event, to qualify for payment. I agree that applications postmarked after the 30 day peri-
od will not be eligible for payment.
I understand that it is my responsibility to resolve race result disputes with the
race organization. ASMC will only make payments based on results sent by the race organization.
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 Civil Code of California and any similar law of any other state, and
I acknowledge that this waiver is an essential term of this 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, the undersigned, certify that the name, social security number and address listed are correct as they relate to the Internal
Racer's Social Security Number: _________-________-___________
Print Racer's Name CLEARLY ________________________________ Age _____Date of Birth _________ Phone (____) ____________
Make Check Payable To : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
S t reet Address ___________________________________ Apt. # _______ City______________________ State _____ Zip ___________
*Sponsored riders need to complete the "Sponsored Rider Affidavit" on reverse side.
Revenue Service Form W-9.

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