Historical Farmall Tractor Show

THIRD ANNUAL HISTORICAL FARMALL TRACTOR SHOW RUNNING OF THE RED TRACTOR DRIVE BUFFALO NICKEL RANCH REGISTRATION FORM MARCH 13, 2010

NAME: (Print) ______

ADDRESS: ______

CITY: ______STATE: ______ZIP: ______

HOME PHONE: ______WORK: ______CELL: ______

E-MAIL: ______

TRACTOR NAME & MODEL: ______YEAR: ____ NOTE: Tractor forward ground speed must be 7 MPH+.

Hold Harmless Agreement: I agree to indemnify the Florida Flywheelers Antique Engine Club, Inc., the Buffalo Nickel Ranch, or anyone connected with the Third Annual Historical Farmall Tractor Show and hold them harmless against all actions, claims, liabilities, losses, cost and expenses that in any way arise in connection with or resulting from this event, including claims without limitations, for bodily injury or death of persons, and for loss of or damage to property, whether the same is due to negligent acts or omissions of Florida Flywheelers Antique Engine Club, Inc., our agents, Stewart Paquette, the Buffalo Nickel Ranch, employees, or otherwise.

SIGNATURE: ______DATE: _____ THIRD ANNUAL HISTORICAL FARMALL TRACTOR SHOW RUNNING OF THE RED TRACTOR DRIVE BUFFALO NICKEL RANCH MODE OF OPERATIONS AGREEMENT MARCH 13, 2010

NAME: (Print) ______

ADDRESS: ______

CITY: ______STATE: ______ZIP: ______

HOME PHONE: ______CELL: ______

I do hereby pledge to obey these rules: Affirm that I hold a valid driver’s license. Agree to follow all Florida traffic laws. Agree not to consume any alcohol prior to or during the tractor drive. Agree to install a Slow Moving Vehicle sign on the rear of my tractor. Agree to carry only adult riders that have a properly mounted seat. Agree to abide by the directions of the group leader. Agree to stay in my assigned order and not pass other tractors. Agree to drive in the designated lane even the road shoulder if so directed. Agree not to pull anything behind my tractor without prior approval. Agree to carry a toe strap or chain. Agree to assist fellow tractor drive participants with a tow if needed. Agree to hold harmless any fellow participant that I permit to tow my tractor. Agree to abide by all decisions and directions of the group leader.

SIGNATURE: ______DATE: _____