Wish I Could of Northeast Louisiana Foundation

23rd Annual Marengo Suicide Swamp Ride

June 7, 2008

$15 per ATV Pre-registered    •OR•    $20 per ATV at the Gate

Mail-in Pre-registration forms must be postmarked by May 25th or they will NOT be processed!

PLEASE READ REGISTRATION CAREFULLY BEFORE SIGNING!!

This form shall be filled out completely before registration will be processed!

General Release

FOR GOOD CONSIDERATION, the undersigned jointly and severally hereby forever release, discharge

and forgive WISH I COULD OF NORTHEAST LOUISIANA, INC., and / or Louisiana Department of Wildlife and Fisheries from any and all claims, actions, suits, demands, agreements and each of them, if more than one, liabilities, judgments, proceedings both at law and in equity arising from the beginning of time and the date of these presence and as more particularly related to or arriving from any damages or injuries to persons And / or property while participating in the Marengo Suicide Swamp Ride sponsored by WISH I COULD OF NORTHEAST LOUISIANA, INC.

Failure to remain on marked entrance / exit routes will result in fines and / or penalties assessed by the owner of damaged property. This release shall be binding upon and inure to the benefit of the parties, their successors, assigns and personal representatives. Alcohol is strictly forbidden on the ride. If you are caught with alcohol, you WILL be fined.

Commercial and / or for profit videotaping is prohibited. By signing this agreement, you and any passengers

understand that any videotaping in any form is for personal, non-commercial use only.

Riding on Friday and / or Friday night, both in the park area and in the outlying community, is FORBIDDEN and will be strictly enforced. Private citizens live in this area and we expect common courtesy be shown to them and their property.

I, _____________________________________, the driver (or parent of the driver if under the age of 16), have read and understand the rules and agreement release for this event. I accept complete and full responsibility for the driver.

_________________________________________ __________________________________________

printed name of driver printed name of passenger /passengers

The address you print below is the one to which all mailings concerning

future rides will be sent. PLEASE PRINT CLEARLY

Mailing Address:__________________________________________________________________________

City: __________________________________________ State: __________ Zip: _____________________

Home Phone: ( ____ ) __________________________ Alternate Phone: ( ____ )

_______________________________________________________________________________________

This area to be Completed by Wish I Could Registrar.

Tag# _______________________ Registrar’s Initials _____________________

This Form May be Reproduced Fill out one Registration for each ATV

Preregistration      Rules and Regulations      Survival Tips