Kansas Dirt Slingers RC Club Member # _________________
Membership Application & Liability Release Form
PLEASE PRINT
Name: ____________________________________________________________
Address: __________________________________________________________
__________________________________________________________________
City State Zip Code
Birth Date: _________________________________________________________
Month Day Year
Contact Info: ________________________________________________________
(Area Code) Phone Email
Membership Fees for the Kansas Dirt Slingers RC Club are as follows:
Single Membership - $15.00 per year
Family Membership – 1st membership $15.00 and $8.00 for each dependant thereafter per year.
Membership entitles members to the following:
Discounted race fees at all club events.
Upon showing your membership card you will receive a 10% discount on RC parts excluding car or truck kits purchased
at The North Kansas City Hobbytown USA store.
Full voting privileges
* Kansas Dirt Slingers RC Club is a non-profit club. Club membership dues pay for racing events, cost associated with the track and other
club operations.
By submitting this form you are stating that you understand and agree that as a club member, you are responsible for
the safety and liability of yourself, your family members, your personal guest and your personal possessions at all times while attending
club functions. You waive any claims against the Kansas Dirt Slingers RC club; it’s officers and club members for any injury or loss that
may occur at club functions. This waiver extends to the owner(s) of property used for any club functions and or facilities.
Please sign stating you understand the terms and agreement of membership
___________________________________________________ ________________________
Signature Date
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Liability Release Form
Self / Parent / Legal Guardian / Duly Authorized Agent(for the above pass holder) (Please circle one)
I am completing this liability form for: (please initial either 1. Or 2. Below)
__________ 1. A minor for whom I am the parent or legal guardian of; or
__________ 2. Myself ( I am age 18 or older)
I understand and accept the fact that the Kansas Dirt Slingers RC Club allows remote control car and truck racing, in it’s
various forms and that this activity could possibly be a hazardous hobby that has many dangers and risk. I realize that,
although injuries are uncommon, they are possible when participating in and around this hobby.
I agree, as a condition of being allowed to use the track area, related facilities and areas on the premises that I: freely
accept and voluntarily assume any and all risk of property damage, personal injury or death, and release the Kansas Dirt Slingers RC
Club, it’s officers, members and property owners from any and all liability for personal injury or property damage which results in any way
from conditions on or about the premises and facilities, negligence, the operations of the track area including, but not limited to, business,
repairs, entertainment, actions or omissions of other patrons on the premises, club officers or property owners of the premises, or my
participation while on the premises, or any other activities on the premises, accepting myself the full responsibility for any and all such
damage or injury of any kind which may result.
As a condition of being a member, or being the undersigned for the above mentioned member, and for permitting member to use any and
all of the facilities of the track premises, I (the undersigned) further agree to assume all risk of personal injury or loss of damage to myself
and or member and any of my (our) property. The Kansas Dirt Slingers RC Club, it’s officers, members or property owner is not
responsible for and may not be held accountable or liable for in any way, any loss, damage, liability, expense, cost or other fees as the
result of any event, accident, injury, or other loss caused by the use of participation in any way at Kansas Dirt Slingers RC Club events.
The undersigned acknowledges that he/she has read and understands said terms as noted in this brief liability release
form and agrees to all conditions without exception. I, the undersigned, have read and understand the above terms. I am signing this
liability release form freely and of my own accord, realizing it is binding upon myself, my heirs and assigns, and in the event that I am
signing on behalf of any minors, that I have full authority to do so, realizing its binding effect on them as well as myself.
Signed,
___________________________ ___________________________________ _________________________
Signature Printed Name Date