2024 OCCRA Membership Form (In Person)

Type of Membership:

If chosen above, Weekend Membership Valid for Race Event:

Rider Information

Rider Name:

Primary Family Member (if applicable):

Date of Birth: Gender:

Parent/Legal Guardian Information (if rider is under 18):

Name:

Rider Address:

Phone: Type of Phone:

E-mail:

E-mail Communication Opt In:

RMATVMC Race Gas E-mail:

RMATVMC Race Gas Account Name:

Emergency Contact:

Name: | Phone:

Award Information:

I would prefer: Jacket Size:

Racer Information

Primary Class Information

Primary Class: Requested Primary Class OCCRA #:

Primary Class Bike/Quad Brand: Model: Displacement: (cc)

Second Class Information (if applicable)

Second Class: Requested Second Class OCCRA #:

Second Class Bike/Quad Brand: Model: Displacement: (cc)

Third Class Information (if applicable)

Third Class: Requested Third Class OCCRA #:

Third Class Bike/Quad Brand: Model: Displacement: (cc)

Fourth Class Information (if applicable)

Fourth Class: Requested Fourth Class OCCRA #:

Fourth Class Bike/Quad Brand: Model: Displacement: (cc)

Payment Amount:

Oklahoma Cross Country Racing Association

Liability Release and Waiver of Rights

Your signature below signifies complete understanding and agreement of these terms

I hereby agree to abide by and be governed by the rules of competition set forth by the Oklahoma Cross Country Racing Association ( OCCRA ) I understand that refusal to abide by and be governed by these rules will result in my immediate disqualification from and event and / or my
disqualification from all OCCRA events and awards. In consideration for being permitted to participate in OCCRA, I agree to indemnity and hold harmless the Oklahoma Cross Country racing Association, sponsoring clubs, promoters, Land owners, sponsors, or any member or officers of
OCCRA for any losses, injuries, or death as a result of my participation in any and all club functions. Included but not limited to, races, practices, trail rides, course preparation, camping, pitting, speculating, work assignments, banquets, parties, meetings, socializing, informal group
gatherings, or any activity associated with OCCRA including travel to and from such activities for the full 12 month calendar season of events. I also agree to the Assumption of Risk and Indemnity Agreement on the reverse side.

RIDERS UNDER 18

Rider is Under 18:

Being the parent and / or the legal guardian of the above minor, I do hereby approve of and agree to the participation of (minor’s name) in the Oklahoma Cross Country Racing Association. I agree to the "Liability Release and Waiver of Rights" clause stated above and the "Assumption of Risk and Indemnity Agreement" of this document for both my child and myself fully and without reservation.

I acknowledge that I have read and understand the Liability Release and Waiver of Rights

Initials : (your initials here)

Printed First and Last Name of Rider (if 18+) or Parent/Guardian (if under 18):

Date Initialed: July 27, 2024

Oklahoma Cross Country Racing Association

Assumption of Risk and Indemnity Agreement

Your signature below signifies complete understanding and agreement of these terms

Oklahoma Cross Country Racing Association (OCCRA ) is a club of general membership dedicated to the tenets of Friends, Family Riding and Racing and organized for the purpose of conducting Cross Country motorcycle races and other club functions to effect those principals.
IN CONSIDERATION of being permitted to compete, officiate, observe, work for, or participate in any way in event(s) or being permitted to enter for any purpose any RESTRICTED AREA (defined as any lands, properties, or boundary areas in or upon which the race or event are conducted, or serviced). EACH OF THE UNDERSIGNED, for himself, his personal representatives, heirs, and next of kin:

1. Acknowledges, agrees and represents that he has or will immediately upon entering any such RESTRICTED AREAS, and will continuously thereafter, inspect the RESTRICTED AREAS which he entered and he further agrees and warrants that if at any time he is in or about RESTRICTED AREAS and he feels anything to be unsafe, he will immediately advise the officials of such and will leave the RESTRICTED AREAS and or refuse to participate further in the EVENT(s)
HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE OCCRA and the persons and entities involved with OCCRA in putting on the EVENT(s) including all the promoters, participants, racing associations, sanctioning organizations or any subdivisions thereof, track operators, track owners, officials, car owners, drivers, pit crews, rescue personal, any persons in any RESTRICTED AREAS, sponsors advertisers, owners and lessees of premises used to conduct the EVENT(s) premises or event inspectors, surveyors,
underwriters, consultants, and others who give recommendations, directions or instructions engage in risk evaluations or loss control activities regarding the premises or EVENT(s) and each of them and their respective officers, directors, shareholders, attorneys, agents, servants, employees, heirs, legal representatives and assigns, (all of whom are hereafter collectively referred to as releases: ) FROM ALL LIABILITY TO THE UNDERSIGNED, his personal representatives, assigns, heirs, and next of kin FOR ANY AND ALL LOSS OR DAMAGES, AND ANY CLAIM OR DEMANDS THEREOF , ON ACCOUNT OF INJURY TO THE PERSON OR PROPERTY, OR RESULTING IN DEATH OF THE UNDERSIGNED, ARISING OUT OF OR RELATED TO THE EVENT(s). WHETHER CAUSED BY THE NEGLIGENCE OF THE RELESEES OR OTHERWISE.
HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the releasees and each of them FROM ANY LOSS, LIABILITY, DAMAGE OR COST that may incur arising out of or related to the EVENT(s) WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
HEREBY ASSUMES FULL RESPONSIBILITY FOR ANY RISK OR BODILY INJURY, DEATH, OR PROPERTY DAMAGE arising out of or related to the EVENT(s) WHETHER CAUSED BY THE NEGLIGENCE OF THE RELESEES OR OTHERWISE.
HEREBY acknowledges that the ACTIVITIES OF THE EVENT(s) ARE VERY DANGEROUS and involve the risk of serious bodily injury and / or death and or property damage. Each of the UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES.
HEREBY agrees that this release and waiver of liability, Assumption of Risk and Indemnity Agreement extends to all acts of negligence by the releasees, INCLUDING NEGLIGENT RESCUE OPERATIONS and is intended to be as broad and inclusive as is permitted by the laws of the province or state in which the Event(s) are conducted and that is any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT AND FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABLITY TO THE GREATEST EXTENT ALLOWED BY LAW.

I acknowledge that I have read and understand the Assumption of Risk and Indemnity Agreement:

Initials of Rider (if 18+) or Parent/Guardian (if under 18):

Printed First and Last Name of Rider (if 18+) or Parent/Guardian (if under 18):

Date Initialed: July 27, 2024

By signing below I affirm that I have fully read and understand the Liability Release and Waiver of Rights, Assumption of Risk and Indemnity Agreement for the member listed on this form and have acknowledged each section with my (or parent/guardian for under 18) initials and name . I have fully verified the accuracy and validity of all information submitted on this membership form. I understand that this membership is valid for the 2024 race season OR for the specific race weekend chosen and indicated at the top of this form. Member or his/her legal guardian is responsible for providing updates to OCCRA if any information on this form changes.

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Your legal name

Your email address

Please Confirm full name and signature.

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Adopt & Sign

Signed by OCCRA Admin
Signed On: January 16, 2024

Timestamp

Audit

January 15, 2024 9:08 pm CDT

2024 OCCRA Membership Form (In Person) Uploaded by OCCRA Admin - webmaster@occra.com IP 68.235.154.37