Waiver And Release Application Form printable pdf download

Advanced Transmission, Inc. (“ATI’s”) Cars

For Christmas Giveaway (“Contest”)

Waiver and Release Application Form

We, Nominator and/or Nominee hereby release, hold harmless, and promise not to sue ATI, any and all sponsors its

officers, owners, directors, employees, or agents (collectively “releasers”) with respect to any and all bodily injury and/or

other personal loss resulting from my participation in the “Contest” whether as Nominator or Nominee in the Contest,

whether caused by the negligence of ATI or otherwise during any respect associated with the Contest upon our

participating in the Contest.

In addition, by entering this Contest, and/or our signature on this form, we certify that we as Nominator and/or Nominee

will provide minimum vehicle liability insurance as required and a valid Driver’s License. We certify that we are over 18

years of age. We have read this Waiver & Release Agreement and will abide by all terms as stated herein. We hereby

agree this Waiver and Release shall be binding upon and enforceable against us, our personal representatives, spouse,

assigns, heirs, and next of kin without limitation.

We have read and understand the terms of the Waiver and Release of responsibility we are about to sign and we

further understand that ATI cannot accept any Nominator or Nominee, without a duly signed Waiver and Release

form. We understand clearly that we have given up substantial rights by signing this Waiver and Release of

responsibility and have signed it freely and voluntarily without any inducement, assurance, or guarantee being

made to us and intend our signature to be a complete and unconditional release of all liability to the greatest

extent allowed by law. By signing this form, we acknowledge that we have met or exceeded the insurance

requirements of the State of Alabama.

We hereby further state that we have read, agreed and received a copy of the Cars for Christmas Contest Rules

and by signing below further agree to abide by said rules.

Nominator’s Signature X_________________________________________________________

Print Name___________________________________ Date______________________________

Phone________________________

Home Address__________________________________________State________Zip__________

E-mail Address _______________________________________Phone (

) _______________

Nominee’s Signature X_________________________________________________________

Print Name___________________________________ Date______________________________

Phone________________________

Home Address__________________________________________State________Zip__________

E-mail Address _______________________________________Phone (

) _______________

Please attach a copy of current driver’s license with Baldwin County address. If said license

does not show proof of Baldwin County address, an alternative proof of address will be

required, i.e., utility bill, phone bill, etc.

Waiver And Release Application Form