<p> 2013 1st Annual</p><p>“Locust Grove Cruise Night” Registration Form</p><p>Name______Phone______</p><p>Address______City, State, Zip______</p><p>Email______Club Affiliation______</p><p>Year______Make______Model______</p><p>Cut-off day for registration is September 20, 2013---NO REFUNDS *Pre-registration $5.00--Day of Show $10.00 Registration Time: 3:00pm-7:00pm</p><p>Make check payable to Locust Grove Chamber of Commerce Send to: Locust Grove Chamber of Commerce P.O, Box 525 Locust Grove, OK 74352</p><p>**Note: If you pre-register by cut-off date, you can pick up your Dash Plaque and Number at the booth located at Clay’s Car Corral, if not, you will need to register at the booth located in the First State Bank parking lot. WAIVER OF LIABILITY & HOLD HARMLESS AGREEMENT</p><p>In consideration for participating and entering the Locust Grove Cruise Night, (hereinafter referred to as CRUISE NIGHT) I hereby release, waive, discharge and covenant not to sue the Locust Grove Chamber of Commerce, Locust Grove Cruise Committee, or any their officers, servants, agents, employees, volunteers, or any other persons(hereinafter referred to as RELEASEES), and hereby release them from all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, accident, or injury including death, that may be sustained by me, or to any property belonging to me, whether caused by the negligence of the RELEASEES, or otherwise, while participating in the Cruise Night, or while in, or upon the premises where the Cruise Night is held, in Locust Grove, Oklahoma, or in transportation to and from said premises.</p><p>It is my express intent that this Waiver of Liability & Hold Harmless Agreement shall bind the members of my family and spouse (if any), and my heirs, assigns, and personal representative, and shall be deemed as a release, waiver, discharge, and covenant not to sue the above named RELEASEES.</p><p>I acknowledge, by my signature, that I have read the foregoing Waiver of Liability & Hold Harmless Agreement, understand it, and sign it voluntarily as my own free act and deed; I am at least 18 years old and fully competent, and I execute this release for full, adequate, and complete consideration fully intending to be bound by the same.</p><p>IN WITNESS WHEREOF, I have hereunto set my hand this 5th day of October, 2013.</p><p>Participant’s Signature______</p>