WAIVER, RELEASE & INDEMNITY AGREEMENT
(Must be completed in order to participate)

In consideration for and as an express condition for my participation in the Mazda Rotaries @ Deals Gap gathering, on April 8th thru 10th, 2005, and for other valuable and sufficient consideration, the undersigned (on his or her behalf and on behalf of his or her heirs, successors, assigns, relatives, and anyone else acting on his or her behalf or on behalf of his or her estate) hereby agrees to completely and forever release, indemnify, and hold harmless Mazda Rotary Car Club of Alabama (MRCCAL), and its officers, sponsors, Mazda USA and shareholders, employees, friends, volunteers, and assigns, from any and all claims or causes of action relating in any way to any injury, illness, loss, or damage I might sustain during the course of, or as a result of my participation in, the gathering planned by Philip Sohn and fellow Rotorheads or transportation to or from those events, regardless of whether such injury, illness, loss, or damage is caused by my conduct; any negligence on the part of Mazda Rotary Car Club of Alabama (MRCCAL), and its officers, sponsors, Mazda USA and shareholders, employees, friends, volunteers, or assigns; or the conduct of an unrelated third party.

I am fully aware of the risks and hazards of being involved in, and participating in, the Mazda Rotaries @ Deals Gap gathering, including the consumption of alcohol. I hereby elect voluntarily to engage therein and I assume the risk of all loss of property and personal injury that may be sustained by the undersigned prior to, during or after the Mazda Rotaries @ Deals Gap gathering. I also agree to accept sole responsibility and liability for any injury or damage, including injury or damage to a third party resulting from my acts or omissions, and agree to hold Mazda Rotary Car Club of Alabama (MRCCAL), and its officers, sponsors, Mazda USA and shareholders, employees, friends, volunteers, or assigns harmless from any lawsuit or claim arising therefrom, and agree to indemnify same for any liability sustained from such lawsuit or claim.

I promise and warrant that I will not file, cause to be filed, tolerate, or permit to remain filed by any person or entity any lawsuit or other claim based upon any injury, illness, loss, or damage I am releasing herein. In the event that such a lawsuit is filed by me or on my behalf, I will indemnify Mazda Rotary Car Club of Alabama (MRCCAL), and its officers, sponsors, Mazda USA and shareholders, employees, friends, volunteers, assigns, and any related person or entity named in such lawsuit or other claim for any expenses or losses, including attorneys’ fees, it incurs as a result.

I further promise and warrant that if anyone should file a lawsuit or other claim against Mazda Rotary Car Club of Alabama (MRCCAL), and its officers, sponsors, Mazda USA and shareholders, employees, friends, volunteers, assigns, and/or any related person or entity relating to any injury, illness, loss, or damage caused by or otherwise based upon my conduct, I will indemnify Mazda Rotary Car Club of Alabama (MRCCAL), and its officers, sponsors, Mazda USA and shareholders, employees, friends, volunteers, assigns, and any related person or entity named in such lawsuit or other claim for any expenses or losses, including attorneys’ fees, it incurs as a result.

I have read the foregoing, I understand it, and I agree to be bound by the provisions of this release. I acknowledge that I am at least 18 years of age.

Signature:

Print Name:

Date: