Winchester Speedpark 2010 Membership Form
Membership fee $60 for 2010 - Family Discount – 1-3 Members pay – 4+ free – Must be child or spouse
Fields Marked by * Are Required
*First Name: *Last Name:
*Address: *City:
*State: *Zip Code:
*Phone: *DOB:
*Age: *Email:
Emergency Contact and Phone (if Different):
Choose 3 RACE #’s NO X’s allowed (Used for One Day Members)
*Race # *Race # Choice 2:
*Race # Choice 3    
*Racer’s Experience please circle one:
Beginner/Novice – Intermediate/Amateur - Expert/Pro
*Bike 1 Size: *Bike 1 Brand:
Bike 2 Size: Bike 2 Brand:
***For contingency choose bike brand and be sure to check results on race day for proper listing***
*You (rider) must race in proper class (Novice Amateur or Expert) and must compete in the highest classification you have held or hold in any organization or events past or present. Check all classes you will be competing in for 2009
50 4-6 50 7-8 50 Open 4-9 65 C 7-9 65 C 10-11
65 B 7-11 65 A 7-11 65 Open 12 and Under 85 C 7-11 85 C 12-15
85 B 7-15 85 A 7-15 Jr Mini 7-11 Supermini 12-16 Youth C 18 & Under
Youth A & B 18 & Under 250 C (Lites) 250 B (Lites) 250 A (Lites)  
450 C (Mx) 450 B (Mx) 450 A (Mx) Open C Open B
Open A 30 C 30 B 30 A 40 C
40 B 40 A MUST CHOOSE ONE: Girls Women
Enter total

We will not be able to issue your membership card until ALL STEPS ARE COMPLETED

  1. Complete this form with a signed, NOTARIZED waiver (other side)
  2. If you are Under 18 also submit a Minor release form NOTARIZED on BOTH sides
  3. Copy of Birth Certificate for age defined classes IF we do not have on file
  4. Membership fee - $60 for 2010 WSP Race series ($50 before 12/31/09)

You must have a Transponder to participate - purchase at track or $10 Day Rental with deposit After 4/1/10 – Forms/Memberships accepted at track only – not by mail

Winchester Speedpark Release Form
512-517 Keene Rd & Bell Ct Winchester, NH

FOR ENTIRE 2010 Season
Motocross Track – Supercross Track

RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT IN CONSIDERATION of being permitted to participate in any way in the sport and activities of Motocross/Supercross under the auspices of Winchester Speedpark LLC and WSP Holdings LLC, I acknowledge, appreciate, and agree that:

1 . The risk of injury from the activity and equipment involved in motorized off road activities is significant including the potential for permanent disability and death, and while particular protective equipment and personal discipline will minimize this risk, the risk of serious injury does exist;

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown EVEN IF ARISING FROM THE NEGLIGENCE of those persons released from liability below, AND ASSUME ALL RESPONSIBILITY FOR MY PARTICIPATION; and,

3. I understand that the activities of motorized off road activities are physically and mentally intense. I understand the rules of play and will comply with all rules and regulations. If I observe any unusual or unnecessary hazards during my participation, I will bring such to the attention of the nearest official as soon as practical AND LEAVE THE AREA;

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, FOREVER RELEASE AND HOLD HARMLESS WINCHESTER SPEEDPARK LLC, WSP HOLDINGS LLC THE OWNERS AND LESSORS OF THE PREMISES USED TO CONDUCT THE MOTORIZED OFF ROAD ACTIVITIES, THEIR OFFICERS, OFFICIALS, AGENTS, PROMOTERS, SPONSORS AND/OR EMPLOYEES ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

5. I understand and agree that the release of Liability AGREEMENT covers each and every motorized off road activity and/or event in which I participate or attend hereafter.

6. I UNDERSTAND THAT THE PROMOTERS OF WINCHESTER SPEEDPARK LLC OR WSP HOLDINGS LLC, DO NOT PROVIDE HEALTH INSURANCE. THE UNDERSIGNED FURTHER AGREES TO ASSUME ALL RESPONSIBILITY FOR DOCTOR, AMUBULANCE, HOSPITAL AND MEDICAL EXPENSES AND ANY LOSS OR INJURY TO ME/THE MINOR AND/OR PERSONAL PROPERTY DUE TO PARTICIPATION IN ANY WINCHESTER SPEEDPARK EVENT.

THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations, statements or inducements apart form the forgoing written agreement have been made.

* I HAVE READ THIS RELEASE I have and will maintain health insurance to race and or practice at WSP and I have Read the Rules for WSP and agree to comply
 
 
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