631-736-8207 •
Home History & Mission Volunteers Member Update Our Facility Photo Gallery Videos - YouTube Upcoming Events How You Can Help Our Sponsors Articles Contact STAR Adoption Form Links
Follow us on Facebook!
Facebook Logo

STAR Foundation’s 4th Annual Motorcycle Run for Wildlife

Saturday, June 17, 2017

Participation in the motorcycle run costs $25 per rider $20 per MC passenger and $20 for those only attending the party. Riders and passengers must register separately and will receive separate raffle tickets for the pit-stop prizes.

Registration fee includes

All proceeds to benefit STAR Foundation Wildlife Rescue and Rehabilitation Programs.

Event Registration & Release Form

Please submit one form for each participant - rider / passenger / party attendee
Required *

First Name *
Last Name *
Particpation *  Rider     Passenger     Party Only
Address *
Apt./Unit
City *
State *
Zip Code *
Date of Birth (mm-dd-yyyy) *
Phone incl Area Code *
Cell incl Area Code *
Email *
   

MOTORCYCLE ACCIDENT WAIVER, RELEASE OF ALL LIABILITY AND ASSIGNMENT OF CLAIMS

As consideration for being allowed to participate in the event(s) described below I agree:

    As consideration for being allowed to participate in the event(s) described below I agree:
  1. I acknowledge that motorcycle activity is a potentially hazardous activity with it the potential for death, serious injury and property loss. These risks are not only inherent to riders, but are also present for passengers, spectators and volunteers. I hereby assume all of the risks of participating, viewing and/or volunteering in this event. I hereby release STAR Foundation and any of the organizing entities of all possible liability. I certify I am at least 18 years old.
  2. I certify that I am physically fit with no known physical or mental impairment and have prepared for participation in the event(s). I acknowledge that this Accident Waiver and Release of Liability form will be used by the event holders, sponsors and organizers of the event(s), in which I may participate and that it will govern my actions and responsibilities at said events. I certify that I am not under the influence of any narcotic, alcohol or other drug that may impair my understanding or judgment and that I will not at any time during the event(s) operate my motorcycle under the influence of any narcotic, alcohol or drug. I certify that I have fully adequate insurance and all liability insurance mandated by New York State law and agree to provide proof, if requested, to cover all medical claims, the motorcycle and any other equipment and any damage or liability I may ultimately be found responsible for, during all travel to the point of my entry into the Ride, the Ride, the period between the end of the Ride and my return to my final destination. I further certify that I have all the insurance required by law and I am licensed and competent to operate a motorcycle in a safe manner and my license has all motorcycle endorsements or certificates required by my state of residence.
  3. In consideration of my being permitted to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me during the event or during my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: STAR Foundation, officers, directors, employees, ride organizers, sponsors, representatives, agents, volunteers and (B) indemnify and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made by other individuals or entities as a result of any of my actions during this event. Accordingly, I do hereby release and discharge STAR Foundation, itís officers, directors, employees, ride organizers, sponsors, representatives and agents, and their officers, agents and employees from all claims, demands, and causes of action of every kind whatsoever for any death, damages and /or injuries which may result from my participation in this event. This shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
  4. I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident and or illnesses during the event(s). I agree to pay for any and all costs related to medical response, treatment and transport on my behalf.
  5. I certify I will wear the personal protective equipment while operating my motorcycle at this event that is or may be required under state law and/or any state in which my participation occurs and that my motorcycle and all required personal protective equipment are in safe operational condition. I agree to abide by the directions/rules given by the organizers of this event and understand that my privilege to ride may be removed without refund if I am in violation of the rules set forth or acting/performing in an unsafe manner, or any manner disruptive to the operation of the event(s). The engine displacement of my motorcycle is at least 650cc, the minimum size allowed for participation.

 By checking this box I hereby certify that I have read the above Waiver, Release and Assignment of Claims in its entirety and I fully understand it and agree to its contents.

Payment
Your registration is not complete without payment. After submitting this form you will be taken to the payment page where you will be able to make a secure payment by credit card via PayPal.