Cycle News - Archive Issues - 1970's

.:.",, ~ ~ ~ ~ ~ ~ ~ ~ ~ GRIPSTERS MOTORCYCLE CLUB, INC. (A Non-Profit Corporation) MOTORCYCLE RACE ENTRY NAME I I I I I I I -'-_ _ ~-------'---.:..------------------------_-- ADDR ESS MA K E O F M . C. ( E N G. N O. A . M . A . NO. _ - _ _ 0 - » J CUB IC CM . ( E X PI R ES ) D I ST . N o . 3 7 RIDING NO. • • • •••• OZO(") (j)S:::OO ::::OOZO-;»02 • -~" _ _ rnO I AM A BONAF I DE M E MBER O F THE _ D ES ER T ( C I RC L E ONE ) M OTOX C LU B . . I (j)::::O - (j) rnz _0" _ in 0 _ -1 ::::0 _ » s: SCRAMBL ES RIDIN G O R Si D EC A R PA R T N E R _ _ s:» ASS UMPT I O N O F T HE RI S K A N D WAIV ER OF P ER SONAL INJUR Y CLAI M "U -I _ 02 - rn o THE UN D ER SI GN ED DOES HEREBY CERTIFY THAT H E IS A DULY QUAL IF IED ICI R C LE ON E) AMAT EUR EX PE RT NOVI C E CLASS M OT OR C Y C L E RID ER HAV ING BEEN SO QUA LIFIE D BY A COMPETENT O R G A N I Z A T I O N . IT IS FURTHER U N D E RS T OOD AND AGREED THAT IN T H E E VE N T I AM INJURED FROM WHATSOEV E R CAUSE DURIN G TH E EVENT COVERED BY THiS APPLICATION . I H E R EWI T H CON S E NT TO AN D A UTHORI ZE F I RS T A ID A N D AMBULANCE S E R V I CE AS PROV IDED B Y T HE SPONSORING CLUB OR PROPERTY OW NER . A N D F U RT HE R H OLD AL L PARTI ES HARMLESS FROM ANY CONSEQUENCES OF SA ID AID . UND ER THE RULES AND SANCTIONS OF THE AMER · I rn 0 - 2::::0 I <» IC AN MO TO R CYC L E A SSOCI ATION . I HER EBY AGREE TO CONFORM AND COMPLY WITH THE RU LES GOVERN ING THI S CONTEST IN - 00 _ p:! 0 CONN E CTI ON WI TH THE COMPET ITION R U LE S OF THE AMER ICAN MOTO RCYCLE ASSOCIATION AND TH E DISTRiC T COMMITTEE AND I F URT HER A G REE TO HOLD BLAMELESS THE AMER ICAN MOTO RCYCLE A SSO CI A T I O N . T H E GRIPSTERS MOTORCYCLE CLUB. I NC. AND ANY PRO PERT Y OWN ER OR OWNER S AN D AGREE TO ASSUME AN Y AND AL L R I S K S F OR A N Y L OS S OR INJURY TO MYSELF DR PROPERT Y IN WH IC H I MAY B ECOME INVOLVED BY REASON OF PARTIC IPATION IN TH IS C O N T EST . I DO ALSO AG REE TO ASSUME R ESPO N S I BI L I T Y FO R ANY P RO PE R T Y D A M AGE WH ICH I K N O W I N G LY INITIATE . I H A V E R EAD THI S EN T R Y BLAN K. C YES NO _ -I Z I 0» _ Or _ 2 rn C SIG NATU RE OF EN T RA NT * I "U-; I rrl 0 _ A G E O F E NT RA N T _ PHONE NO . DATE I rrl ~ _ 0::::0 I O-;~~~r=rrl ~ z::::O (") rrl -; rn ::0 . » 0 -;"U 2rrl 0 ::::o r S: -;0-;2~ f; OJ "U 0 (j) ::0 -I rn =" rn ::0 -I rn ::0 (") 0 =" Z ~ 2 ~ s: 2 (j)rrl° 0 rn 0 9 ::u ~ZOJ -;o:E"tI =" :E rrl I 0 ~ o ~ rn r ::0 "U "U I'T1 C =" en r ~ rn ::u 0 - §5 s: ~~:EOJ2-;2en Z GJ O ::::0 ::::0 » iJ (") rrl);: . -< I - rn rn 3: r 0 rn r2' OJ s: OJ --I P rn "U -< ::::0 0 0 -< » C "U ~ ~ rn rZOUl 2 P = m :J::::=- S s: ~~ I. 2 ~ g: o I'T1 en r • BEING OF LEGAL A G E . DO H ER E B Y CERTIFY TH AT I A M THE _ OF A MINOR . I FURTH E R S AYET H TH AT I H ER EB Y G I VE MY CON SE NT FOR SAID _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • M INOR . TO COMP ETE I N ALL GR I PSTERS MOTORCYCLE CLUB I N C. E V E N T S H E R E B Y RE L EA SI NG THE A .M.A.. D I ST R I CT 37 SPO R TS COMM ITTEE . PROP ERTY OWN ERS. A N D GR IPSTERS MOTO RCYC LE C LUB d ay of ON A _ N OTAR Y PUBLIC IN AND _ • BEFORE ME . THE UN DERSIGNED, FOR SA ID COUNTY AND ST A T E, PERSONALLY AP PEARED _ KNOWN TO ME TO BE THE PERSON W H O SE NAME. IS SUBSCRIBE D TO THE WITH IN INSTRUMENT AN D ACKN O WLE DGE D THAT IN C. F O R ANY AND A LL LIABILI TIE S. THIS STATEMENT OF CONSENT I S V A L ID UNTI LJANUARY 1,197 1. d ate d thi s ST A TE OF C A LIFOR N IA COU NT Y OF E XECU T ED T HE SAM E . I N W ITNESS W H E R E O F , I HA VE HEREUNTO SET MY HAND AND AFFIXED MY OFFICIAL SEAL THE DAY AND YEAR IN THE CE RTlFI · C A TE FI RST A B O V E WRI TTEN . 19 _ _ . - -NO TARY PU B L I C IN A ND FOR SAI D COUNTY AN D STATE. MAIL ENTRY TO: 0 - 2 50 CC. · · · SMALL BIKES GRIPSTERS M.C. P.O. BOX 425 BUENA PARK, CALIF. 90620 25 1 c e. · · · OP EN BIG BIKES - GRIPSTERS M.C. P.O. BOX 416 BUENA PARK , CALIF. 90620 SID E HACKS 2. ~ ~0:E ::U - . Z rrl I'\) O-;-;:E rrl ::E » 0 rn ~ :z ::::0 ::::0 Z I;;! (") co 0 0 » » co 2 • !T'J (j) -; GJ rn 2 ~ o» - rn rrl I < co I "U:Z _ 0° - . (j) I OJ rn Or - rn 71 I x -~ I I " I ::OC5~ s: (") ,~ » CD Z C s: OJ rn ::::0 (j) I 0 3: 0 '? c: I'\) Z g s: O"OJ-I - OJ fil -. -< - " I'\) Io » g ~ 0 I'T1 rn :-0 ::u o x:O ::l. Gl ~.0:;; "tl Ql en OJ en ~ -I :-" ~ 3: r+ =" - OJ I'T1 \DC))' 0 rn (")O::u 0 P (j) Ql X en C)) I = ~ I'\) o ' (j)'- Ul "3: I'\) \D 00 (") rn C ) ) ' - ---I ~ :::::c: ' l l m Q ~ ::JCI =tI C ~ ~CI) 35: Ci) ""3 ---I ~ ""3 ::JCI n ~< t:J ~ ~ n ~ ;c:~ I 0 OJ "U ~ "U 0:;; rrl c rn ~. en ~. 2 CD (") Ql rn => "U '" ::u CI) 1'T1:1> ~ en ::z:: ::I:.... (") . - _ Z ::r ~ --I~ I'T1 -d g: en en' . . . . . . . . - . . . ." I 2 Z ~ =" ° tD ~ 2 - » =" ." CI) rn ........ r+::U 0 e3:::! I C? I'T1 c: ~ 0 0 » I'\) I'T1 Z 'll Z (") ~ ~ rr,~ I I'T1 A n ::0 -< ~ >< C o: n » 0 C'J:l ~Q en 0 Z ...... ~ (") < 0 r-:I> I'T1 en ::u rn 0 C'J:l :I> ::::0 ::::0 0 en Z 3: I'\) » z C ~""3Q I I );: _ rn ST A TE ME N T O F NO TARY FOR A PPLICANTS UND ER 2 1 Y EA RS OF AGE ) I'T1 r+~~ I (") - ,.,-< _ -I OJ * I R E Q U I RE D ::I: ~ -I ::I: 0 l::r -< -I OJ I'T1 en (j) =" ::u:l> I C)) ::::0 ::0 2 - -a ~ ~=c: r~,.... ~ OJ:I> 0 - -<. Z GJ o: -I OJ en -» I :I> A r ...... CI-IZo~=~(") - OJ5~'~b~~ s: 0 .OJ-< ~ 8 "U » I OJ ~ C3:~r Q -::Eo =" enen_-I ..... C::I> Z-I.ii0rtl C c: 0 ~"tI m -; co - (j»> (")~-;OJO~~r ° c ~ . . 'S: o: r ~. --I ~ Z :0 0 :I> rn C ~» en s: r+ -< r+ 0 l= I S =0 n S >< ,... c: ~ ~ .. e- rn ~ OJ :I> - ="Z rn (j) C ~ ca (") i.,...~~~~~~~~~~ CYCLE NEWS ~ r-- Page 19

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