Prairie Tractor Pullers 
Prairie Tractor Pullers 
   PTP Home      2017 Entry

OFFICIAL PRAIRIE TRACTOR PULLERS SPRING SHOOTOUT ENTRY FORM

March 24 & 25, 2017
 

AGREEMENT OF RELEASE

1.         HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE PRAIRIE TRACTOR PULLERS SPRING SHOOTOUT AS AN ASSOCIATION, INCLUDING ALL ITS CORPORATE ELECTED AND APPOINTED OFFICIALS, ALL MEMBERS OF COMMITTEES, REFEREES AND INSPECTORS, ITS INDIVIDUAL MEMBERS, ITS MEMBER CLUBS, AGENCIES OF GOVERNMENT WHICH CONTROL ESSENTIAL EVENT SITES, FINANCIERS AND FIRM WHICH RENDER ESSENTIAL GRATIS, INCLUDING ALL OFFICERS, AGENTS AND EMPLOYEES OF THE FOREGOING AND VOLUNTEER WORKERS ASSISTING IN SANCTIONED PRAIRE TRACTOR PULLERS SPRING SHOOTOUT EVENT ACTIVITIES, ALL HEREINAFTER REFERRED TO AS “Releases” from or for any and all liability to me, my personal representatives, heirs, next of kin, successors and assigns, for all loss or damage from bodily, or death or damage to property of the undersigned which in any way grows out of or upon alleged breach of any statutory duty or obligation: and

2.         HEREBY AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS the releases and each of them from any loss, liability, damage, or cost the incur due to the presence of the undersigned in or upon the restricted area or in any way competing, officiating, observing, or working for or for any purpose participating in the event and whether caused by the negligence of releases or otherwise; and

3.         HEREBY ASSUME FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH, OR PROPERTY DAMAGE due to negligence of releases or otherwise while in or upon the restricted area, and/or while competing, officiating, observing or working for or for any purposes participating in the event; and

4.         EXPRESSLY ACKNOWLEDGES AND AGREES THAT THE ACTIVITIES OF THE EVENT ARE DANGEROUS AND INVOLVE THE RISK OF SERIOUS INJURY AND/OR DEATH AND/OR PROPERTY DAMAGE. THE UNDERSIGNED further expressly agrees the foregoing Release Waiver and Indemnity Agreement is intended to be as broad and inclusive as is permitted by the law of the province or State in which the event is conducted, and that if any portion thereof is held invalid, it is agree that the balance shall, notwithstanding, continue in full force and effect.

I HAVE READ THE AGREEMENT OF RELEASE ABOVE AND HAVE SIGNED THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY FOR ALL PRAIRIE TRACTOR PULLERS SPRING SHOOTOUT SANCTIONED EVENTS. IN CONSIDERATION OF PRAIRIE TRACTOR PULLERS SPRING SHOOTOUT PROMOTIONAL EFFORTS ON BEHALF OF THE SPORT, I HEREBY ASSIGN ALL COMMERCIAL PICTURES, MERCHANDISE SALES, AND BROADCAST RIGHTS TO PRAIRIE TRACTOR PULLERS SPRING SHOOTOUT.

_______________________________________________________________________                          _____________________________________

                                                SIGNATURE – MUST SIGN                                                                                                DATE

Driver’s Name: __________________________________________________________Age: _______________________

(please print)

Parent, Guardian, or Owner signature________________________________________Date: ______/______/___________

(parent or guardian signature required if driver is under 18 yrs. of age)

Email address: ______________________________________________________________________________________

Owner’s Name: ________________________________________________Address: ______________________________

City: ____________________________State: ___________Zip: ___________Phone: _____________________________

Tractor Make and Model: _______________________________________ Tractor Name: __________________________

Engine Brand __________________________    Single_____  Flat Twin ______  V-Twin ________ Must select one!

                                                                                (excluding super mod, 4 cyl, and open classes)

Select 1 (one) class only – a separate entry form per tractor, per class required – ENTRY FORM MAY BE COPIED

_____1050 Stock  (Sat)$50                                     _____1050 Stock V-Twin (Friday)$50   _____1050 Stock Altered (Friday)$50

                                                                                                                                                                                                                                                (single & flat twin only)

_____1050 Stock Alt – 12 HP (Friday) $50

_____1050 Sport Stock (v-twin) (Sat)$50              _____1050 Super Stock Open (Sat)$50  ____1050 Pro Stock (Friday)$50

_____1250 Super Mod (Friday)$50                        _____1350 .Open (Friday)$50                 _____1050 Super Stock(NQS rules)(Sat) $50

______1050 Pro V-Twin (Friday)$50      ______    1050 Missouri Super Stock (single)(Friday) $50      ______1350 Open (Sat)$50

_____1050 Stock Youth (Friday)$25      Enter Fee $50.00 all classes except Youth (includes driver pit pass & 1 additional)

Schedule is subject to change                                                                              Total Entry Fees: ___________________

Additional Pit Passes - $10.00 each                                                     _____      Additional Pit Passes: _______________

Pit Passes may also be purchased day of event                                                  Total Collected: ____________________

Tractor #: _________________________

Make checks payable to: Prairie Tractor Pullers

Mailing address: Prairie Tractor Pullers – Ken Long, 409 Prospect St NE, Blairstown, IA 52209

Pre-Registration Deadline: Postmarked no later than March 3, 2017 to be in pre-event draw.

Please Check All  Rules

** Pull position is determined by random drawing prior to event**                 

**Any class with 30 or more entries will be split into heats**    ** Entries postmarked after 3/3/2017 or day of event entries will be charged $10.00 extra fee **

**Tech will be open Thursday 3:00pm – 7 :00pm, Friday 7:00am – 1:00pm, & Saturday 7:00am – 9:00am  **Pulling Starts 2:00pm on Friday & 10:00am on Saturday

**Payback 70% - Top 10 places in all classes.                                 **Fuel Specific Gravity Test – MAX .750 & Alcohol – Water Test

Find more information about Prairie Tractor Pullers at  - www.Prairiepullers.com

Or call Ken Long – 319-454-6397   nightmarepulling@hotmail.com

Questions of rules or classes:   Jason Johnson – 319-239-5369   jasonjohnson308@gmail.com

Jim Malmberg – 319-530-3996