WISCONSIN GARDEN TRACTOR PULLERS, INC.
MEMBERSHIP APPLICATION AND LIABILITY RELEASE FORM
Name:______________________________________ Age:_______ No. of Yrs. Pulling:_______
Address:____________________________________ Phone #:____________________________
City:___________________________ State:_______ Cell Phone #: ________________________
Zip Code: _______________ Email: ________________________________
Classes to choose from:
Stock = (S) Lt. Pro Mod = (LPM) Pro Stock = (PS) Hvy Pro Mod = (HPM) Lt. Super Mod = (LSM) Hvy Super Mod = (HSM) Open Super Stock = (OSS) Outlaw = (O) Unlimited Outlaw = (UO) Heavy Unlimited Outlaw (HUO)
Misc. Information such as: Owner/Builder, Sponsors, Awards, Championships, ect...:
________________________________________________________________________________
________________________________________________________________________________
Waiver: (Note: Parent or Guardian must sign for minor child)
I agree to indemnity Wisconsin Garden Tractor Pullers, Inc. (Club) and all of its related organizations
(Promoters and Weight Transfer Machine Owners/Operators), directors, officers, and volunteers, and
hold same harmless from and against any and all damages, liabilities, costs and expenses (including
but not limited to attorney's fees) which may be incurred as a result of my participation in any Club
event or activity.
I agree that by signing this from I release and discharge Wisconsin Garden Tractor Pullers Inc., its
directors, officers, members, owners/operators of the weight transfer Machine, and Promoters of
W.G.T.P. pulls from any and all known or unknown damages, injuries, losses, judgments and/or claims
from any causes whatsoever, that may be suffered by entrants, family members, or guests while
attending or participating in said events. I also understand that each participant will be solely
responsible for his/her own vehicle and personal property.
I state that I am of lawful age and legally competent to sign this document; that I understand the terms
herein; and that I have signed this document as my own free act.
Child’s Name (print):__________________________Relationship:______________________
Driver/Parent Name (print):
Signature:________________
Dated:___________ Full Membership Fee Paid $_________ Trial (One Day) Fee Paid $__________
Accepted on behalf of W.G.T.P. INC. by:Title:______________________________
Date:_____________________
