2011 Morton Loggers' Jubilee

Loggers' Jubilee Invitational Lawnmower Questionnaire

NAME __________________________________________Age ___________

Telephone Number (Day) _____________________ (Night) ________________

Address ________________________________________________________

Sponsor(s) ______________________________________________________

_______________________________________________________________

Nickname __________________________________

Mower # ___________     T-shirt size  ____________

Racing highlights/ comments: _________________________________________

_______________________________________________________________

***************************************************************
HOLD HARMLESS AGREEMENT

I, ______________________________________________, do hereby release and
discharge the Morton Loggers' Jubilee Committee, their designees, officers, agents,
volunteers, employees, and the property owners of which the race is held, from all claims,
demands, and causes of action of any kind whatsoever for any damages and/or injuries
to myself, my pit crew, or my property while I willingly participate in this racing event.

Signature ____________________________________________________

Date ________________________________  Mower # _______________

Pit crew #1 Name (PRINT) ______________________________________

Signature ____________________________________________________

Pit crew #2 Name (PRINT) ______________________________________

Signature ____________________________________________________

SEND ALL CORRESPONDENCE AND QUESTIONNAIRES/WAIVERS TO:
Jim Schaffer 
P.O. Box 1221
Morton, WA.  98356

Please return by July 31st