Name
First Name
Last Name
E-mail
example@example.com
Phone Number
-
Area Code
Phone Number
Will you be bringing a guest? (1 allowed)
Yes
No
What type of car will you be bringing?
Make, Model, Year, Color
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Release Form
By signing this release, you waiver your right to hold accountable or proceed with legal action towards the organizer of the LLS Fundraiser Ralley, ADAM PRECHTL, from any damages incurred due to the nature of this event. Damages include, but are not limited to: speeding tickets, physical damages to your vehicle due to other patrons, pedestrians, or yourself, offensive language from other patrons causing emotional disturbance, parking fines, misdemeanors or felonies involving the driver, or any other physical or emotional injury. The organizers of this event pledge to run this event in the safest manner to their abilities, and will adhere to any current COVID-19 social distancing practices enforced during the time of the event. Your digital signature below signifies that you agree to the above terms.
First Name, Last Name
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