Mid Bay Rotary Club and North Bay Fire Control District 1st Annual Fire Truck Pull
2015 Team Registration Form
Friday, September 25, 2015 Proceeds go to Mid Bay Rotary Club
Winn Dixie Shopping Complex
TEAM REGISTRATION INFORMATION:
• A TEAM IS MADE UP OF 10 PEOPLE, ALL MEN, ALL WOMEN OR CO-ED.
• EACH TEAM MEMBER PAYS $10.00 ($100.00 FOR A TEAM) TO ENTER AND WILL RECEIVE AN EVENT T-SHIRT
• DEADLINE TO ENTER IS SEPTEMBER 18, 2015
EVENT RULES AND TEAM INFORMATION
• All participants must be a minimum of 16 years of age and have a signed Waiver submitted with the team registration.
• Each Captain will be responsible for the submission of all registration paperwork.
• In the event a team member cannot participate after he/she has been registered, the Team Captain may appoint an alternate team member.
• Teams will pull the Fire Truck twenty (20) feet, fastest pull time wins.
• Teams may station their pullers on the rope in any order but may not tie the rope around the anchor puller.
• Rope attachments, such as Velcro, are not permitted.
• Pullers may remove slack from the rope but must not begin pulling until signaled.
• The signal to begin the pull from the Referee is…”Ready, Set” – and the blowing of an air horn.
• Timing begins at the sound of the horn and continues until the truck is pulled the required distance.
• Referee will signal the end of the pull and the truck brakes will be applied.
• Gloves are permitted and encouraged, shoes are required. NO FLIP FLOPS!
• For general information, a 1 ½” diameter rope will be used for the competition.
1st Annual Fire Truck Pull
Oktoberfest 2015 Bluewater Bay Winn Dixie Shopping Plaza
WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
In consideration of participating in the 1st Annual Fire Truck Pull, hereinafter “FAFTP,” I represent that I understand the nature of the FAFTP and that I am qualified, in good health and in proper physical condition to participate in the FAFTP. I also acknowledge and agree that if I believe the conditions surrounding the FAFTP are unsafe, I will immediately discontinue participation in the FAFTP.
I fully understand that the FAFTP involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own or others actions, or inactions, or those of others participating in the FAFTP, the conditions in which the FAFTP takes place or the negligence of the “Releasees” named below; and that there may be other risks, either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of my participation in the FAFTP.
I hereby release and discharge the North Bay Fire Control District, Mid Bay Rotary Club, The Winn Dixie Shopping Plaza and all other affiliated agencies involved with Oktoberfest, and their respective administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and if applicable, owners and lessors of the premises, on which the event takes place (each considered one of the RELEASEES herein) from any liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the Releasees or otherwise, including negligent rescue operations; and I further agree that if, despite this release, waiver of liability, and assumption of risk, I or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any loss, liability, damage, or cost which any may incur as the result of such claim.
I have read this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, and understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.
ALL SUBMISSIONS TO BE TURNED IN TO:
NORTH BAY FIRE CONTROL DISTRICT
1024 WHITE POINT ROAD
NICEVILLE, FL 32578
INQUIRIES DIRECTED TO SHAWN THURSTON (850)376-8501 OR SPTHURSTON@NORTHBAYFD.ORG