ANDRETTI ROSWELL 2017 RACING KAMP SCHEDULE

June 12- June 16 June 26- June 30 July 17- July 21

July 31- August 4

Racing Kamp: Each kamper will learn Kart and Track safety, engine maintenance and proper steering and braking techniques on both the Junior and Adult (Advanced) courses. At the end of the week, kampers will be evaluated on the track for a chance to earn their license to graduate from the Junior Track to drive on our Adult (Advanced) Road Course for a whole year! Kampers will also have time on the Ropes Course, Dark Ride motion theater, Rock Wall, Zip Line and Racing Simulators FYI- •The price of kamp is $375/week/kamper and includes a t-shirt, lanyard, all activities, materials and a nutritious lunch.

•We accept cash and all major credit cards. We do not accept checks or gift cards.

•You can register your kamper in our Front Office. Please bring with you the completed Registration Form and waiver.

•Kampers must be at least 48” tall and between the ages of 8-14 to participate.

•Kamp will run 9:00am- 4:00pm each day. Drop-off will be between 8:00am- 9:00am and Pick-up will be between 4:00pm- 5:00pm. There will be a fee of $25 for any child left after 5:00pm.

•You will need to sign in and sign out your child each day. For the child’s safety, anyone other than you that will be picking up your child needs to be written on the Registration Form or your child will not be released to them until the parent is contacted.

•Full payment is due upon Registration. We do not accept deposits or partial payments to hold spots. We can no longer accept payments over the phone or email. Payments must be made in person in the Front Office only.

•There is a maximum of 20 kampers per week. Once that number is reached, that session will be closed out.

We look forward to hosting your little driver this summer! Follow Andretti Race Kamp on Facebook! **The program is not licensed and is not required to be licensed by the state.

ANDRETTI RACE KAMP REGISTRATION- ROSWELLPlease check the week(s) that apply. Kamp is $375/week:

June 12- June 16 June 26- June 30 July 17- July 21 July 31- August 4

Kamper’s Name__________________________________ Kamper’s DOB ____ /____ /______

Parent/ Guardian Name____________________________________________________________________

Parent Cell __________________________ Parent Email________________________________________

Street Address___________________________________________________________________________

City/State/Zip______________________________ T-shirt size: YS YM YL YXL AS AM

Kamper may also be picked up by___________________________________________________________

Please list any allergies, dietary needs, health concerns, medications, etc. that you feel we should know about for the kamper’s well being during the week of kamp.____________________________________________________________________________________________________________________________________________________________________________________________________________________

Emergency Contact InformationName/ Relation_______________________________________ Cell______________________________

Name/ Relation_______________________________________ Cell______________________________

To participate in Andretti Race Kamp, your child must be at least 48” tall and between the ages of 8-14 years old. Andretti Race Kamp starts at 9:00am and ends at 4:00pm each day. An additional fee of $25 will be charged for any kamper left after 5:00pm. Disrespectful behavior, inappropriate language, and inappropriate physical contact directed towards counselors, kampers, or equipment will not be tolerated and the kamper may be removed, without refund, from kamp. The program is not licensed and is not required to be licensed by the state

I have read the above statement and agree to all the terms stated.

Parent/ Guardian Signature________________________________________ Date____________________

**Max 20 kampers per week. Sessions are subject to availability. Spot is reserved once payment is made in full.

For Office use Only:

Payment Received:_____________________ CC___ Cash___ Received by:__________________________________________

JR. ANDRETTI INDOOR KAP-TING & GAMES

Race Name (Optional) ______________________________ _

Fi rs t & Last Name ____________________ Date of Birth _______ _

Parent/Guardian Name------------------------------------

Home Address __________________________________ _

Ci ty/State/Zip _________________________________ _

Email Address __________________________________ _

Home Phone----------------------- Fax------------

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

Andretti Race Kamp 2017 Date of Kamp

IN CONSIDERATION of being permitted to compete, officiate, obseive, work for, or participate in any way in the EVENTS(S) or being permitted to enter for any purpose any RESTRICTED AREA (defined as any area requiring special authorization, credentials, or permission to enter or any area to which admission by the general public is restricted or prohibited), EACH OF THE UNDERSIGNED, for himself, his personal representatives, heirs, and next of kin:

1. Acknowledges, agrees, and represents th at he has or wil I i mm edi ately upon entering any of such RESTRICTED AREAS, and wi II con tin uou sly thereafter, inspect the RESTRICTED AREAS which he enters, and he further agrees and warrants th at, if at anytime, he is in or about RESTRICTED AREAS and he feels anything to be unsafe, he wi II immediately advise the officials of suchand if necessary will leave the RESTRICTED AREAS and/or refuse to participate further in the EVENT(S).

2. HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the promoters, participants, racingassociations, sanctioning organizations or any su bd ivi si on thereof, track operators, track owners, officials, car owners, drivers, pitcrews, rescue personnel, any persons in any RESTRICTED AREA, promoters, sponsors, advertisers, owners and lessees ofpremises used to conduct the EVENT(S), premises and event inspectors, suiveyors, underwriters, consultants and others whogive recommendations, directions, or instructions or engage in risk evaluation or loss control activities regarding the premises orEVENT(S) and each of them, their directors, officers, agents and employees, all for the purposes herein referred to as"Releases," FROM ALL LIABILITY TO THE UNDERSIGNED, his personal representatives, assigns, heirs, and next of kin FOR ANY AND ALL LOSS OR DAMAGE, AND ANY CLAIM OR DEMANDS THEREFOR ON ACCOUNT OF INJURY TO THE PERSON OR PROPERTY OR RESULTING IN DEATH OF THE UNDERSIGNED ARISING OUT OF OR RELATED TO THEEVENT(S), WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

3. HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the Releasees and each of them FROM ANY LOSS,LIABILITY, DAMAGE, or Cost they may incur arising out of or related to the EVENT(S) WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

4. HEREBY ASSUMES FULL RESPONSIBILITY FOR ANY RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE arisingout of or related to the EVENT(S) whether caused by the NEGLIGENCE OF RELEASEES or otherwise.

5. HEREBY acknowledges that THE ACTIVITIES OF THE EVENT(S) ARE VERY DANGEROUS and involve the risk of seriousinjury and/or death and/or property damage. Each of THE UNDERSIGNED, also expressly acknowledges that INJURIESRECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THERELEASEES,

6. HEREBY agrees that th is Release and Waiver of Lia bi I ity, Assumption of Risk and Indemnity Agreement extends to all acts ofnegligence by the Releasees, INCLUDING NEGLIGENT RESCUE OPERATIONS and is intended to be as broad and inclusiveas is permitted by the laws of the Province or State in which the Event(s) is/are conducted and that if any portion thereof is heldinvalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect -

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

Signature _________________________ Date _____ _

Signature of ParenVGuardian ____________________ Date _____ _