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OUTBACK OFF ROAD ADVENTURE PARK Number ________ Membership Form Official use only
Please print clearly and complete all sections for the Outback Off Road Adventure database. Membership fees do not pertain to any special events held at the Outback Off Road Adventure Park.
Date: ________________ MEMBERSHIP FEE: $10
Last Name: __________________________ First Name ______________________ Middle Initial: _________
Street Address: ________________________________________ Phone #1 Home: ( ) ___________________
City: ___________________________________________________ Phone #2 Cell: ( ) ___________________
State: _____________________ Zip Code: ______________ email address: _____________________________ D.O.B. ______-______-______ Check Box If Passenger Only √ : □Do not fill out vehicle information if you will always be a passenger Vehicle information
Make: ______________________ Model: _____________________ Year: _______________________
Emergency Contact Name: ____________________________________ Relationship: ____________________
Emergency Phone Number: ( ) ____________________ MAKE CHECKS PAYABLE TO: Outback Off Road Adventure Group This membership is valid for 1 year from the date you join. 655 New Castle Road Outback Off Road Adventure Park is open by appointment only. Butler, PA 16001 % Meridian Off Road Center, Inc. Outback Off Road Adventure Park must be notified of any vehicle changes or personal data. A valid ID must be presented each time you enter the park along with your membership card.
I hereby give up all rights to sue or make any claim for damages due to negligence or any other reason whatsoever against OUTBACK OFF ROAD ADVENTURE GROUP, LLC, MERIDIAN OFF ROAD CENTER, INC., AWRCS, Sponsors and all other persons, participants or organizations connected with any trail rides and/or all events for injury to property or person I may suffer while participation in each trail ride and/or event and while upon Outback Off Road Adventure Park premises. Any photo’s, recordings, videos and such created, submitted, and or collected during or in regard to this park, become sole property of “OUTBACK OFF ROAD ADVENTURES GROUP, LLC”. Any tips, instructions or suggestions given by “OUTBACK OFF ROAD ADVENTURE GROUP, & MERIDIAN OFF ROAD CENTER, INC. & or participants”, are merely suggestions. This event is for entertainment purposes only. “OUTBACK OFF ROAD ADVENTURES” is not affiliated in any way with any motor company such as but not limited to: JEEP, GM, TOYOTA, LAND ROVER, etc., or any aftermarket manufactures such as but not limited to: BDS SUSPENSION, MICKEY THOMPSON, EXTANG., etc., each of which have registered trademarks independent of this event.
THIS IS A RELEASE Participants Signature: _____________________________________________
Signature (parental signature if under 18): _______________________________
———————————————————————————————————————————- Official Use Only
OUTBACK OFF ROAD ADVENTURE PARK AUTHORIZED SIGNATURE _______________________________ |
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Call: (724) 285-5082 between 9:00 a.m. & 6:00 p.m. Monday thru Friday
9:00 a.m. to 1:00 p.m. on Saturday
We are not open to quads or bikes.
All fees / guidelines and rules are subject to change. Additional fees may apply to Special Events. |
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Call: (724) 285-5082 between 9:00 a.m. & 6:00 p.m. Monday thru Friday
9:00 a.m. to 1:00 p.m. on Saturday
We are not open to quads or bikes.
All fees / guidelines and rules are subject to change. Additional fees may apply to Special Events.
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