2008 OKLAHOMA STATE CHAMPIONSHIP SERIES

MEMBERSHIP APPLICATION  (MEMBERSHIP FEE $25.00)  -One rider per form please

RIDERS NAME

________________________________________________________________________________

Last                                                                         First                                                               MI

2007 OSCS MEMBERSHIP NUMBER_____________

DATE OF BIRTH_____________    AGE____   # OF YEARS RACING____

ADDRESS____________________________ CITY_________________    STATE____ZIP__________

PHONE (____)_____________EMAIL___________________________________________________

I UNDERSTAND THAT THE OKLAHOMA STATE CHAMPIONSHIP SERIES (OSCS)., THE LAND OWNERS, LEESSEES, PROMOTERS, AND TRACK OFFICIALS OF THE OKLAHOMA STATE CHAMPIONSHIP SERIES ARE IN NO WAY RESPONSIBLE FOR INJURY TO PERSONS OR DAMAGE AND/OR LOSE OF PROPERTY. I KNOW THAT MOTORCYCLE RACING IS DANGEROUS! I HEREBY GIVE UP ALL MY RIGHTS TO SUE OR MAKE CLAIM FOR DAMAGES DUE TO NEGLIGENCE OR ANY OTHER REASON WHATSOEVER AGAINST THE LANDOWNER, PROMOTERS, AND TRACK OFFICIALS OF THE OKLAHOMA STATE CHAMPIONSHIP SERIES, EMPLOYEES THEREOF, AND ALL OTHER PERSONS, PARTICIPANTS, OR ORGANIZATIONS CONDUCTING OR CONNECTED WITH THE OSCS TO INJURY TO PROPERTY OR PERSON I MAY SUFFER, INCLUDING CRIPPLING INJURY OR EVEN DEATH, WHILE PREPARING FOR AND/OR PARTICIPATING IN OSCS EVENTS AND WHILE ON THE EVENT PREMISES. AND RELYING UPON MY OWN JUDGMENT AND ABILITY, I ASSUME ALL SUCH RISKS OF LOSS AND HEREBY AGREE TO REIMBURSE ALL COSTS TO THOSE PERSONS OR ORGANIZATIONS CONNECTED WITH THE OSCS FOR DAMAGES INCURRED AS A RESULT OF MY NEGLIGENCE.  I KNOW THAT THE OKLAHOMA STATE CHAMPIONSHIP SERIES DOES NOT PROVIDE RIDER MEDICAL INSURANCE. MY PARENT/GUARDIAN OR I AM RESPONSIBLE FOR MY OWN HEALTH/ACCIDENT INSURANCE.

RIDER’S SIGNATURE_____________________________ DATE____________

PARENT/GUARDIAN SIGNATURE *MUST BE SIGNED IF RIDER IS UNDER 18 YEARS OF AGE*

PARENT'S SIGNATURE____________________________ DATE____________

MEMBERSHIP VALID 01 JANUARY – 31 DECEMBER 2008-------PLEASE ENCLOSE YOUR CHECK OR MONEY ORDER FOR $25.00.

Submit To: OSCS - 10100 Gee Drive - Oklahoma City, OK 73165