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Seat Belt Convincer Waiver

Please submit one registration per participant.

I am the parent or legal guardian of the participant. I permit my minor child or ward (the “Minor”) to participate in all aspects of the Seat Belt Convincer Demonstration (the “Event”) organized by the Indiana Criminal Justice Institute – Traffic Safety Division (ICJI-TSD), Alliance Integrated Marketing Services, LLC, Alliance Sport Marketing, LLC, Indianapolis Motor Speedway, and affiliated sponsors and personnel (collectively, the “Releasees”). I agree and attest that:

  1. I understand the nature of the Event and the risks involved. I deem the Minor to be qualified to participate in the Event. I know the Minor’s experiences and capacities related to the Event’s activities and risks. I expressly assume any and all risks associated with participation in the Event. I voluntarily accept those risks on behalf of the Minor and myself.
  2. I consent to the Minor’s participation in the Event and hereby agree to pay the Indiana Criminal Justice Institute, Alliance Integrated Marketing Services, LLC, sponsors, instructors, and their directors, officers, agents, and employees for any losses resulting from the Minor’s negligent or intentional damage or harm to any equipment or persons facilitating the Minor’s participation.
  3. I agree not to hold any of the Releasees responsible for any loss that may result from participation in the activity on behalf of the Minor or myself.
  4. I hereby release, waive, and discard the right to sue any of the Releasees if any loss results from participation or observance of the Event. I waive this right on behalf of the Minor, myself, and our personal representatives, assigns, heirs, and next of kin.
  5. I agree to assume responsibility for and cover any medical expenses that may result from the Minor’s participation in the Event.
  6. The Event may include an activity known as the Seat Belt Convincer Demonstration Device. ICJI-TSD, Alliance Integrated Marketing Services, LLC, its officers and employees, and any other sponsor are released from any and all manner of liability, claims, demands, or suits in law or equity, for any and all injuries, damages, or losses to me, the Minor, or our property, both known and unknown and foreseen and unforeseen, incurred or suffered as a result of the Minor’s participation. This includes, but is not limited to, climbing on, seating in, riding on, or dismounting from the Seat Belt Convincer and any other equipment utilized during the demonstration.
  7. I know of no condition, injury, or infirmity of the Minor which could be aggravated by the forces associated with a 7-mph automobile collision.

I sign this agreement on my own behalf and on behalf of the Minor. I have read this document and I am signing it freely. I understand the legal consequences of signing this document, including (a) releasing the Releasees from all liability on my and the Minor’s behalf, (b) waiving our rights to sue the Releasees, and (c) assuming all risks of the Minor’s participation in this Event, including travel to and from the Event or any incidental activities. I understand that I am responsible for the acts and obligations of the Minor as described herein and agree to be bound by the terms of this document.

I hereby acknowledge and agree to the following terms in consideration for being permitted to participate in the Seat Belt Convincer Demonstration (the “Event”), organized by the Indiana Criminal Justice Institute – Traffic Safety Division (ICJI-TSD), Alliance Integrated Marketing Services, LLC, Alliance Sport Marketing, LLC, Indianapolis Motor Speedway, and other affiliated sponsors and personnel (collectively, the “Releasees”):

  1. I understand the nature of the Event and the potential risks involved, including but not limited to bodily injury, property damage, and emotional distress. I acknowledge that participation in the Seat Belt Convincer simulates the physical forces of a low-speed automobile collision (approximately 7 mph), which may result in injury. I voluntarily accept and assume all such risks, known and unknown, foreseen and unforeseen, associated with my participation.
  2. I certify that I do not have any known medical condition, injury, or physical limitation that could be aggravated by participation in the Seat Belt Convincer. I accept full responsibility for any medical costs or expenses that may arise as a result of any injury or health condition related to my participation.
  3. I agree to indemnify and hold harmless the Releasees from any loss, liability, damage, or cost they may incur due to my participation in the Event or any damage I may cause to equipment or other participants.
  4. I hereby release, waive, and forever discharge the Releasees from any and all liability, claims, demands, actions, or causes of action whatsoever, whether in law or equity, arising out of or related to any injury, loss, or damage to person or property that may be sustained by me while participating in or observing the Event, including those arising from the negligence of the Releasees.
  5. The Event may include use of the Seat Belt Convincer Demonstration Device. ICJI-TSD, Alliance Integrated Marketing Services, LLC, Alliance Sport Marketing, LLC, Indianapolis Motor Speedway, their officers, employees, and any affiliated sponsors are released from any and all manner of liability, claims, demands, or causes of action—whether known or unknown, foreseen or unforeseen—for any and all injuries, damages, or losses incurred from my participation. This includes, but is not limited to, climbing on, seating in, riding on, or dismounting from the seat skid or any other equipment used during the demonstration.
  6. I know of no condition, injury, or infirmity that could be aggravated by the forces associated with the 7-mph simulated crash experience. I accept full responsibility for verifying my fitness to participate.

I have read this waiver and understand its contents. I am signing this document freely and voluntarily. I understand the legal consequences of this release, including (a) assuming all risks of participation, (b) waiving my right to sue, and (c) releasing the Releasees from all liability for injuries or damages I may suffer. I agree to be bound by the terms of this document.

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