SIGN ME UP!
2001 SUZUKI MOTOCROSS CONTINGENCY RELEASE/ENROLLMENT APPLICATION
In consideration of being permitted to participate in the Suzuki Contingency Program during the 2001 season, I (PRINT NAME)
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , for myself, my successors, heirs and assigns, release and forever disch a rge American Suzuki Motor
C o r p o ration ("ASMC") and its affiliates, a g e n t s ,e m p l oye e s ,s e rva n t s ,o f f i c e r s ,d i re c t o r s , and authorized SUZUKI dealers ("related parties") from all claims,
a c t i o n s , 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 Suzuki Contingency Program for 2001.
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
i n j u r i e s , including death, and damages to property caused by my act or omission arising out of my participation in the Suzuki Contingency Program for
2 0 0 1 , and from all judgements re c ov e red and from all expenses incurred in defending said claims or suits.
I further agree that without compensation, my name, as well as any photogra p h s ,p i c t u re s ,s l i d e s , or movies taken of myself or made in connection with my
participation in the Suzuki Contingency Program for 2001, or any reproduction of the same, may in any manner be used by A S M C, or by any person, c o r p o-
ration or association authorized by A S M C.
I am in good health and have no physical conditions that would prevent me from participating in motocross ra c i n g.
I understand that contingency payments will not be made to classes that have fewer than seven (7) riders. Only 2000 and newer U. S. RM models are eligi-
ble 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 period will not be eligible for payment. I understand that it is my responsibility to resolve race result dis-
putes 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 ex i s t
in my favor at the time of signing the re l e a s e, w h i ch if I knew or suspected such claims, would have materially affected my willingness to sign the re l e a s e.
I HEREBY WAIVE MY RIGHTS under Section 1542 of the Civil Code of California and any similar law of any other state, and I ack n owledge that this wa i v e r
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
g u a rdian 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 Revenue
Service Form W-9. Riders collecting Suzuki contingency subject to IRS Form 1099.
PLEASE COMPLETE IN FULL DETAIL:
Racer's Social Security Number: ________________ - ________________ - ________________
Print name CLEARLY ___________________________________ Age ________ Date of Birth __________ Phone (___) ___________
Street Address _________________________________ Apt# ______ City _________________________ State ____ Zip ________
*Sponsored riders need to complete the "Sponsored Rider Affidavit" on reverse side.
PLEASE TURN OVER TO COMPLETE APPLICATION
At Suzuki we want every ride to be safe and enjoyable. So always wear a helmet,eye protection and protective clothing. Never ride under the influence of alcohol or other drugs. Study your
owner's manual and always inspect your Suzuki before riding. Always supervise young riders. The RM series motor cycles are for closed-course events and related practices only.
