2013 Racer Application

Derby Day is Sunday, September 22nd, 2013. Fill out this application and use PayPal (or send in a check for) $25 entry fee and signed waiver to Montague Soapbox Derby, c/o MCTV Channel 17, 34 Second Street, Turners Falls, MA 01351. Applications must arrive no later than noon Monday, September 2nd, 2013, to be included in the pre-printed Racer Info book, which will be sold at the concession stands. Only the first 100 applications will be accepted. Please put a valid return address on the envelope and send only checks or M.O. Entrants must be 8 years or older on Derby Day. Entrants under 18 must be accompanied by a responsible adult. Applications without a signed waiver will not be accepted. No exceptions. You may also download and print the paper form, if you prefer. Racers can also find the RACER RULES on that page, which are required reading for the race.

Racer Information

Receive a confirmation via email

Note: Entrant MUST be 8 years or older Race Day

Will count as signature.

Team Information

If you have raced previously, please select number. DO NOT pick a number if you have not raced before.

Payment Info

On the next page you will be presented with a PayPal button. You may use PayPal to pay for your racer fee using any major credit card, or you may print the next page and mail it in with a check. If paying with a credit card, you may pay for multiple racers, and then come back and just fill out the form for the additional racers afterwards.

2013 Montague Soapbox Derby Waiver

I plan to build and drive a Soapbox Derby Vehicle to be entered in the Montague Soapbox Derby being held in Montague, Massachusetts, on Sunday, September 22nd, 2013, hereby certify that I will build my Derby Vehicle in full compliance and spirit with the 2013 Montague Soapbox Derby Rules.

I (parent/guardian) hereby grant permission for my son/daughter/ward to enter the Montague Soapbox Derby (sign only if the Racer is under the age of 18), and assume all responsibility outlined for racers below, in lieu of my son/daughter/ward.

Further, I understand and agree that as a prerequisite to competing in the Montague Soapbox Derby that I, together with my Derby Vehicle, shall undergo and pass an inspection conducted in the Staging Area, by Officials of the Montague Soapbox Derby.

I further understand and agree that such inspection shall be conducted using the manner and methods deemed appropriate by the Derby Officials in their sole discretion, to determine compliance with the rules, spirit and specifications applicable to the Derby and that the decisions of the officials regarding qualification and disqualification and compliance with the rules, spirit and specification applicable to the Derby shall be final and binding upon me and all other parties.

Finally, in consideration of the benefits received as a result of the participation herein, and for the mutual benefits received by myself and the other participants herein, I hereby assume all risks associated with this activity and specifically waive and release any and all claims, rights, causes of action, demands or otherwise, whether for personal injuries, property damages, or any other loss, damages or expenses which I may have against the Montague Soapbox Derby, Montague Community Cable, Inc., and any and all sponsors, agents, volunteers, board members, employees full or part time, interns, or associates of any status whatsoever arising from or in any manner related to my participation in the Montague Soapbox Derby and/or any activities incidental or related thereto. I willingly enter into this Derby with this spirit in mind.

Check all boxed that apply