Badger Membership Form
By submitting this form, I hereby grant the following waiver, release of liability, and indemnity to the hereafter listed individuals and entities, in consideration of, and as a condition of, said individuals and entities permitting the Participant to attend the above set forth Event (hereinafter referred to as “Event”) and to participate in its Activities (defined below). The Activities of the Event as to which the Participant’s waiver, release of liability and indemnity apply include, without limitation, Activities of the Event such as swap meets, flea markets, field events and competitions, road runs or trips, presentations, meetings, banquets and/or any other activities a part of the Event in which the Participant attends and/or participates (collectively hereinafter referred to as “Activities”). The individual and entities to whom the herein waiver is granted and which are hereby released and indemnified by the Participant include (1) THE ANTIQUE MOTORCYCLE CLUB OF AMERICA, INC.; (2) the BADGER HERITAGE CHAPTER (sponsoring local chapter thereof); (3) the owner(s), landlord(s) and/or tenant(s), whichever is applicable, providing the premises being utilized for the Event and its Activities; (4) the vendors and suppliers providing services and/or goods at or for the Event and its Activities; and (5) each of the above set forth entities’ and individual’s respective directors, officers, employees, volunteers, managers, heirs, representatives and assigns (all such individuals and entities collectively hereafter referred to as “Providers”).

By the Participant’s signature hereunder the Participant affirmatively states and confirms that the Participant understands and agrees that the Activities inherently may carry risk of injury, death and/or property loss. The Participant agrees to and hereby assumes the risk of all such dangers and losses while attending the Event and participating in the Activities, and the Participant, for the Participant’s self and for the Participant’s estate, heirs, representatives and assigns, further agrees to hold harmless and release the Providers from any and all liability for any injury, death and/or property loss that the Participant may suffer during or as a result of the Participant’s attendance of the Event and participation in the Activities.

The Participant hereby agrees to indemnify the Providers and hold the Providers harmless from any and all cost or loss resulting from any injury or property loss, or other negligence, caused by the Participant which occurs as a result of the Participant’s attendance of the Event or participation in the Activities, including, without limitation, all claims, losses, demands, actions, causes of action, costs, loss of service, expenses, damages, judgments, and execution that the Participant may have had, now has, or may have, against any of the Providers in respect thereto.

This waiver, release and indemnity shall run for the duration of the Participant’s attendance of the Event and the duration of the Participant’s participation in the Activities of the Event.

Member's Name *
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AMCA# *
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City *
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Co-Member's Name (if registering a Couple's membership)
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