2015 Plane Pull Registration Form
Saturday, May 2, 2015
UPS Terminal / RDU Airport
1480 International Drive
Morrisville, NC 27560
Contact Name:
E-mail address:
Team Name:
Company/Organization Name:
Work Phone: (
)
Cell Phone: (
)
Company/Organization Address:
City:
State:
Zip:
Team Registration:
___ I would like to register my 5 - member team for the 2015 SONC Plane Pull
(Note that all participants must be 14 years or older. For questions, contact Leslie Moyar at
919-719-7662 x 123 or lmoyar@sonc.net)
My organization will be participating on a contribution basis, with a minimum guarantee
of $800 payable the day of the event.
____ I would like more information about the 2015 SONC Plane Pull
____ I cannot participate this year, but please accept a tax - deductible donation of $
Payment:
____ My check is enclosed
____ Please send an invoice for the participation fee
____ Please bill my credit card:
Account #:
Exp. Date:
Authorized Signature:
Sponsorship Levels :
Please check the following if you are interested in sponsoring the 2015 SONC Plane Pull.
Senior Pilot
$15,000
17 teams, logo on Torch Run & Event T-shirt,
marketing benefits
Pilot
$10,000
13 teams, logo on Torch Run T-shirt, marketing
benefits
Co-Pilot
$6,000
8 Teams, logo on Torch Run T-shirt, marketing
benefits
Flight Engineer
$3,000
4 teams, logo on Event T-shirt, marketing benefits
Passenger
$1,000
1 Team, company or team name on T-shirt
Money must be raised and turned in by April 22, 2015.
Completed registration forms should be submitted to Michelle Zaski at mzaski@sonc.net or through fax a
919-719 -7663.
2015 Plane Pull™ to benefit Special Olympics North Carolina
Release and Waiver of Liability, Assumption of Risk,
and Indemnity, and Parental Consent Agreement (“Agreement”)
Name:
Email:
Address:
City:
Phone: (
State:
Zip:
)
Waiver and Release
In consideration of participating in PLANE PULL 2015, I represent that I understand the nature of
the event and that I and/or my minor child am qualified, in good health and in proper physical
condition to participate in such event. I acknowledge that if I and/or my minor child believe the
event conditions become unsafe, I and/or my minor child will immediately discontinue
participation in the event.
I fully understand that the event involves risks of bodily injury, which may be caused by my own
actions, or inactions, those of others participating in the event, the conditions in which the event
takes place, or the negligence of the “releasees” named below; and that there may be other risks not
known to me or not readily foreseeable at this time; and I fully accept and assume all such risks
and all responsibility for losses, costs, damages, and liabilities of any kind whatsoever, arising out
of or in any way relating to my and/or my minor child’s participation in this event.
I hereby release, discharge, and agree to hold harmless, Special Olympics North Carolina, Delta
Airlines, United Parcel Service Co., Raleigh Durham Airport Authority, Credit Suisse, and/or
respective administrators, directors, agents, officers, volunteers, and employees, other participants,
and sponsors, advertisers, and if applicable, owners and lessors of premises on which the Activity
takes place, (each considered one of the “Releasees” herein) from liability, claims, demands, losses,
or damage of any nature whatsoever caused or alleged to be caused in whole or in part by the
negligence of the “releasees” or otherwise, including negligent rescue operations; and I further agree
that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf,
makes a claim against any of the Releasees, I will indemnify, save and hold harmless each of the
releasees from any loss, liability, damage, or cost which any may incur as the result of such claim.
I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any
other record of this event for any legitimate purpose.
I have read this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY
AGREEMENT understand that I have given up substantial rights by signing it and have signed it
freely and without any inducement or assurance of any nature and intend it be a complete and
unconditional release of all liability to the greatest extent allowed by law and agree that if any
portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in
full force and eeffect.
Printed name of participant
Date
Signature of Participant (only if age 18 or over)
Signature of Parent/Legal Guardian (if participant under age 18)
2015 Plane Pull Team Roster
Saturday May 2, 2015
UPS Tarmac/RDU Airport
Team Captain:
Team Name:
Company:
Phone #: (
)
E-mail:
Member Name
E-mail Address
Waiver Signed?
T-shirt Size
Total $
SM-XXXL
collected
Completed registration forms should be submitted to Michelle Zaski at mzaski@sonc.net or through fax a
919-719 -7663.