Teammate Questionnaire

Welcome, future Rebelles! This form is intended to help competitors find and connect with potential teammates. The questions are intended to help you learn more, find out relevant information, and open up communication. How much information you chose to provide up front is up to you. This information will not be shared publicly. It is designed to be a helpful tool for you. Please fill out the form below to receive a link to our database of submissions. Please note, the information you post will be visible to the group of interested competitors within this database.

Full Name*

FirstLast

City/State/Country*

Phone*

Area CodePhone Number

E-mail*

Have you competed in the Rebelle before?*

What is your preferred role (driver, navigator, or switching roles)?*

Off-road experience level*

Navigation experience level*

Tell us a little bit about yourself. What are your goals during the rally? (Place top-10, finish, have fun, maybe all of the above?)

Share one random, fun or interesting fact about yourself

Do you have a vehicle with which you would like to compete? If so, please provide year/make/model*

Are you planning on fundraising to cover rally costs?*

Best way to get in touch (email, phone, Facebook?)*

Best time of day to connect*

Notes

By providing the above information (“Information”) to Rebelle Rally Enterprises, LLC (“Rebelle Rally”) and signing the form below, I acknowledge that I am an “Interested Competitor.” I authorize Rebelle Rally to upload my Information into a database (“Database”) that may be accessed by Rebelle Rally employees and agents and other Interested Competitors. I covenant and agree that I will only use other 'Interested Competitors’ Information contained in the Database for the purpose of finding a partner to participate in the Rebelle Rally with me; that I shall at all times respect the privacy and requests of other Interested Competitors; and that I shall use the Information and Database in a reasonable manner. I acknowledge that if Rebelle Rally determines that I have misused any Information or the Database, in its sole discretion, Rebelle Rally may deny me access to the Database and Information.

I acknowledge that Rebelle Rally makes no warranty, express or implied; promise; or contract of any kind regarding my success in locating a partner, that the partner will be compatible with me, that the partner is able to complete or compete in the Rebelle Rally, or that the other Interested Competitors’ Information is accurate.

I waive all claims and causes of action of every kind against Rebelle Rally and release, defend, and hold harmless Rebelle Rally, its managers, members, employees, and agents from all claims and causes of action, of every kind, regarding the use of my Information, other Interested Competitors’ use of my Information, and my use of other Interested Competitors’ Information and the Database. If I assert any claim or cause of action against Rebelle Rally, including its managers, members, employees, and agents, and Rebelle Rally is the prevailing party, I agree that Rebelle Rally shall be awarded its attorney’s fees and costs.

I, as an Interested Competitor, understand and agree to the terms and conditions of this form.*

Date*