Waiver and Assumption of Risk

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Registration, Waiver(Release) and Indemnification
WWII Convoy & Liberation of Nouveau Oxford
I,_______________________________________, in connection with my participation in the Keep ‘Em Rolling Convoy & Liberation of
“Nouveau Oxford” held jointly by the re-enactors portraying the 4th Infantry Division Military Police, the 2nd Gebirgsjaeger Division, and
other re-enactor units, on Saturday, September 15, 2012, state that I have voluntarily elected to participate in the convoy and liberation, to
include passing through and stopping in the Borough of New Oxford, Adams County, Pennsylvania, in order to recreate the liberation of a
French town in World War II.
In connection with the convoy and liberation events to be held in the Borough of New Oxford, I hereby agree to release, indemnify
and hold harmless the 4th Infantry Division Military Police Platoon, the 2nd Gebirgsjaeger Division, and other re-enactor units, the Borough
of New Oxford, its elected and appointed officials, officers, employees and agents, the New Oxford Area Historical Society, its board
members, officers, employees and agents, and CSX Corporation, its subsidiaries, board members, officers, employees and agents, from any
and all kind of liability and all claims for damage to person(s) or property as a result of my participation in this event. By signing this
Release and Indemnification, I understand and agree to assume all risks associated with my participation in this event and I further agree to
be legally bound by the terms of this Release and Indemnification.
The specific facilities, instructions, equipment and/or activities are as follows: The use of the roads of the Borough of Gettysburg,
PA and New Oxford, Adams County, PA and/or any private and public property the convoy traverses. Owners and Users of all vehicles in
the Convoy and Owners and Users of all property, public and private, on which we participate. I am aware and acknowledge that I may be
entering, riding in, and exiting a vehicle, and that blank ammunition (including a simulated bazookas, artillery pieces, and smoke grenades)
may be fired during the event.
I fully understand that there are certain risks and dangers associated with the facilities, instructions, equipment and/or activities that
can not be eliminated regardless of the care taken to avoid injuries and that these risks and dangers have been fully explained to me. I fully
understand the risks and dangers involved. I fully assume the risks and dangers involved as acceptable to me, and I agree to use my best
judgment in undertaking these activities, and I agree to follow all safety instructions.
I am a competent adult, aged _____________, and I assume these risks of my own free will. I have read this Waiver and
Assumption of Risk and I understand its terms. I understand that I am giving up substantial rights and I acknowledge that I intend by my
signature that this be a complete and unconditional release of all liability to the greatest extent allowed by the law.
[ ] AXIS PARTICIPANT Sign and date (skip section below) [ ] Horseman [ ] Vehicle Driver (Type) _________________________________
Unit ______________________________________ Unit Kommandant _____________________ Rank _________________________
[ ] ALLIED PARTICIPANT - CHECK HERE
I understand that this year the convoy will take on a “combat readiness” attitude. This means
that all participants will: be prepared at all times for combat along the convoy, when stopped, just about all dismount and assume combat
positions or if staying in vehicles, to be armed and at the ready. Once we arrive in town and stop as the battle commences, all will dismount
and engage the enemy or at least appear to. All ALLIED participants must agree to follow orders of the designated battle commander once
the battle begins.
My PRIMARY Role will be: DRIVER [ ] (Vehicle______________________________________________) or RIDER [_] (Choose one)
My SECONDARY Role will be: DRIVER/RIDER ONLY [ ] BLANK FIRING COMBATANT [ ] Weapon __________________________
Driver/ Rider Only: Those “dressed” but unable to be involved in battle (Reason: health, no ammo, special role like Photographer)
Blank Firing Combatant: Those willing to fire blanks.
Specialty Role if applicable: MP [ ] MEDIC [ ] NURSE [ ] CORRESPONDENT/Photographer [ ] OTHER _______________________
UNIT ________________________________________ Unit Commander _________________________ RANK ____________________
(Vehicle Owners: Mounted Gun? Y ____ N ____ Type(s) ___________________________)
Artillery or special weapons (Like Bazooka, Smoke Grenades, etc.) __________________________________________________________
------------------------------- SECTION BELOW TO BE FILLED OUT BY ALL PARTICIPANTS ------------------------------------------------Dated _________________ Registration fee: $10 except no fee for vehicle drivers/owners
[ ] collected
(ADMIN ONLY)
______________________________________
Signature of Participant
________________________________________
Printed Name of Participant
CITY ____________________________________________________________________
STATE _______ ZIP CODE ______________
EMAIL ______________________________________________________________________________ PHONE CTC _____________________________
Mail completed form to:
In order to avoid a Paypal fee, please follow these steps for Paypal otherwise, cash, money order or check is fine.
Arthur Buker
1. Click on "Send Money"
2. Type in [email protected] 3. Type in the amount
Ike's Convoy
4. Click on the "Personal" tab 5. Click on the "Other" button
6. In the subject line, type in
2319 Old Frederick Road
"Farm" & in opt’l. message type Name, City, ST, Allied or Axis unit name 7. Click Send Money
Catonsville, MD 21228
Or email it to:
[email protected]
Please make checks payable to Arthur Buker
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