KLMJ/KQCR Antique Tractor Parade

Saturday, August 10th, 2013

Alternate Driver Application

 To register an alternate driver, please fill out the following form.  This will register an alternate driver as an official participant of the KLMJ/KQCR Antique Tractor Parade.  A second tractor may NOT be used.  All rules and regulations apply to the alternate driver.  A registration fee of $25.00 is required, which includes 2 name plaques, lunch, afternoon snack break, and a gift bag.

 PERSONAL INFORMATION           (Please print clearly)

YOUR NAME  (as it will appear on your name plaque)_____________________________________

Your Address______________________________________________________________

City _____________________    State _______    Zip_________    County_________________

Phone:        Home_______________________    Cell_______________________________

Your Lead Driverís Name______________________________________________________

 

Have you been on the KLMJ/KQCR Antique Tractor Parade before?  Yes___          No____

 

The KLMJ/KQCR Antique Tractor Parade will start in Bristow and will go to Aredale, Hansell, Beeds Lake, Hampton, Geneva, Dumont, and back to Bristow.  This year, the ride will stop for a one-hour tractor show during Hamptonís Annual Summerfest Celebration in Bandshell Park, between noon and one p.m.  Breakfast will be in Bristow from 6 to 9 a.m. (not included in the alternate price), a morning break is planned in Hansell (not included), with lunch in Hampton, an afternoon break in Dumont.

 

I hereby, for myself, my heirs, my executors, and administrators, waive any and all rights and claims for damage I may have against individuals associated with this event, its agencies, representatives, and successors for any and all injuries suffered by me in this event.  I attest and verify that I have full knowledge of the risks involved and am physically able and sufficiently trained to participate in this event.  KLMJ/KQCR Radio reserves the right to limit the number of tractors in the ride in order to control traffic and the safety of the event. I give my permission for the free use of my name and picture in any broadcast, telecast, or print media account of this event.

 

 

 

Signature________________________________________ Date_____________________

 

 

 

 

 

 

 

 

KLMJ/KQCR Antique Tractor Parade

Alternate Driver Safety Pledge

 

I, _______________________________, hereby pledge to hold safety as the highest priority on the KLMJ/KQCR Antique Tractor Parade.  The safety of my fellow riders and the public traveling on the route is of the utmost importance.  I pledge to obey the following rules (please place a check mark beside each rule so we know you have read them):

 o     To hold a valid drivers license.  People with invalid licenses will NOT be allowed on the ride.

o     To follow all traffic laws.

o     To NOT carry riders.

o     To stay with my assigned group.

o     To depart during my assigned groupís designated time.

o     To drive on the shoulder if needed.

o     To not have bicycle companions.

o     To not pull campers, trailers, or carts.

o     To follow the designated route.

o     To abide by the decisions of the Ride Management Teams, based on the National Weather Service, in the event of inclement weather.

o       NO CABS ARE ALLOWED.

o       A SLOW MOVING VEHICLE SIGN IS REQUIRED.

o       REARVIEW MIRRORS ARE REQUIRED.  IF YOU DO NOT HAVE A MIRROR, YOU WILL NOT BE ALLOWED TO PARTICIPATE.  WE WILL BE CHECKING ALL TRACTORS THE MORNING OF THE RIDE! 

o       NO PASSING IS ALLOWED AT ANY TIME.

I understand breaking these rules will result in the denial of all future applications.  Repetitive violators will be asked to leave the ride per the Ride Management Team.

 

Signature:___________________________________________       Date:_____________________________

 

To be an official participant of the KLMJ/KQCR Antique Tractor Parade, please complete, sign, date, and submit all forms.  Please only one registrant per form.  Upon acceptance of registration, a confirmation letter will be sent.  If you have any questions, please call Mandy Strother at 641-456-5656 or email mandy@klmj.com .

.  Please mail registration form, safety form, and check to: KLMJ/KQCR Antique Tractor Parade, ATTN: Mandy Strother, PO Box 495, Hampton, IA 50441.