Poker Run Non Member Single Rider Registration - ARIZONA FALLEN HERO MEMORIAL RIDERS

Today's Date *

Rider's Name *

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Rider's Address *

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Rider's Cellphone *

Rider's Email *

Email

Confirm Email

In case of a medical emergency, who can we contact? *

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WAIVER and RELEASE OF LIABILITY: I/We know that participating in a motorcycle ride is a potentially hazardous activity. I/We should not enter unless I/We am medically able and properly trained. I/We assume all risks associated with participating in this event including, but not limited to: falls, contact with other participants, the effects of the weather and traffic, all such risks being known and anticipated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry to participate in the ARIZONA FALLEN HERO MEMORIAL RIDERS (AZFHMR) POKER RUN (herein after the “Event”) to be held on April 1st, 2023, in various locations throughout Arizona, I/We, intending to be legally bound, do hereby for myself, my heirs, my executors and administrators agree as follows: I/We do waive and forever release any and all rights and claims for any damages and liabilities of any kind arising out of my participation in the Event against all persons, entities and agencies involved with promoting and holding the Event, including but not limited to the coordinators of the Event, the AZFHMR®, their sponsors, vendors of the event, their agents, successors, representatives and assigns even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I/We assume the risk of all bodily injuries, including death, resulting there from, and personal injuries to me and damage to and loss of my property, including loss of use thereof and any other indirect or consequential damages, resulting directly or indirectly, wholly or in part, from my participation in the Event and while traveling to and from the Event. I/We also understand, while riding in the Event, any careless act on my part and/or failure to follow the rules of the event will result in my immediate disqualification to participate in the Event. I/We hereby agree, for myself and/or for a minor under the age of eighteen for whom I/We am/are signing, to indemnify, defend, and hold the entities named above harmless from and against any and all claims, liabilities, losses and damages, costs, expenses (including attorney’s fees) judgments and penalties arising out of any of my, and/or said minors, acts, or omissions to act. I/We understand that the Event reserves the right to use any and all participant’s names and/or likeness with regard to promotional and/or advertising materials. PLEASE TYPE YOUR AND YOUR PASSENGER(S) FULL LEGAL NAMES BELOW. *

By checking the box, you certify that you are at 21 years of age or older and that you have read, fully understand the terms of this agreement. You are aware that this is a release of liability, a contract and sign it of your own free will. *

I agree

RIDER RULES AGREEMENT (Please carefully read before checking the box) Everyone must submit a completed registration/signed waiver/signed ride rules and agreement forms and entrance fees prior to participating in the Event. The ride you are registering to participate in an event that is exclusively dedicated to a fundraising event in support of the Arizona Fallen Hero Memorial Riders (AZFHMR) in their mission of providing financial support to First Responders who are seriously injured or killed in the line of duty. Thus, we respectfully request all participants, remain respectful to all other participants during any per-ride, post-ride, or the actual ride and/or any other Event(s) functions and remember the reason for the ride(s). The “EVENT COORDINATORS” are there for your protection, please follow all of their directions. All rules are enforceable by any participant of the Event. Report any violation of the rules to an Event Coordinator immediately. Last minute registration and payment will be accepted the day before and the day of the Event. Location of check-in, last minute registration and updated information will be posted on our website https://azfhmr.org/. The ride will start at approximately 10:00am and will conclude at 4:30pm at Click Billiards, 3325 N. 1st Avenue, Tucson, AZ. All vehicles (motorcycles, cars, trucks) must be properly registered and insured. Drivers must be properly licensed. The use of alcohol or any substance that affects the ability to operate or control his/her vehicle or which may be considered hazardous to the health and safety of participants and spectators is strictly forbidden. Any participant found to be in violation of this rule will be immediately removed from the Event. All State and Local traffic laws will be observed. Uniformed police officers may be present during the ride(s) and will take enforcement action on all observed violations of State and Local traffic laws. NO stunt riding or other negligent or reckless conduct of any kind will not be tolerated. Any participant found to be in violation of this rule will be asked to immediately leave the Event. This is a self-paced ride and we ask that you arrive at a determined time and location to enjoy the barbecue after the ride. In the event of an emergency, our Event Coordinators will have contact information for proper individuals to assist. If for any reason you are unable to participate or are asked to leave the Event, the registration fees are non-refundable. This is NOT a race or timed Event. BE SAFE! If you are riding or driving, observe all traffic laws and be a defensive, courteous motorist. HAVE FUN, enjoy the ride and camaraderie with the participants of the Event(s). You are riding for a great cause, and we are appreciative you being a part of it. PLEASE TYPE YOUR AND YOUR PASSENGER’S FULL LEGAL NAME BELOW. *

By checking the box, you agree to abide by the rules as set forth in this agreement. *

I agree

I understand there will be a $10 increase for all registration received on the day of the event. *

I understand

In order to receive updated information regarding the AZFHMR charity events, including this event, I understand I must agree to receive a newsletter from the AZFHMR. You may unsubscribe from the newsletter at any time. Please Note: Some email providers automatically place our newsletter in their Promotion or Spam folders. Please watch these folders for our newsletter. Also, you may unsubscribe from the newsletter at any time.

I agree to receive AZFHMR mewsletters.

Payment type *

Credit Card - $ 30.00
Cash - $ 30.00
Credit Card Payment Day of the Event - $ 40.00
Cash Payment Day of the Event - $ 40.00