KLMJ/KQCR Antique Tractor Parade

Saturday, August 10th, 2013

 

Driver Application

PERSONAL INFORMATION (Please print clearly)

Name (as it will appear on your name plaque)_______________________________________________________

Address___________________________________________________________________________

City ______________________    State _______    Zip_____________    County_________________

Phone: Home_________________________________    Cell ________________________________

 

Have you been on the KLMJ/KQCR Antique Tractor Parade before?Yes__ No___

 

The KLMJ/KQCR Antique Tractor Parade is $50 per tractor and includes breakfast, morning and afternoon

snack breaks, lunch, dinner, a photograph, and a gift bag  This year, we’ll start in Bristow and go to Aredale,

Hansell, Beads Lake, Hampton, Geneva, Dumont, and back to Bristow.  The parade will have a one-hour tractor 

show at Hampton's Annual Summerfest Celebration in Bandshell Park, between noon and 1 p.m.  A morning break is planned in Hansell, lunch in Hampton, and an afternoon break in Dumont.

TRACTOR INFORMATION

Tractor: Make __________________________    Model_______________________    Year________ 

Will you have a rider?  Yes__  No__          Name of rider:____________________________________

Speed:8 mph___________       12 mph__________       16 mph_______

The tractor speed stated on this form will be used to determine group placement.  Please test your tractor speed BEFORE choosing a traveling speed.  Always estimate slower!

___ Yes, I will be registering an alternate driver.

  Name of alternate driver:____________________________________________________________

 If you have an alternate driver, an Alternate Driver Application and Safety Pledge will be mailed to you with your confirmation letter.  It is your responsibility to get all the information to your alternate. 

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

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 except on an approved buddy seat.

o       To stay with my assigned group.

o       To depart during my assigned group’s 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 list only one person per registration 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.

 

SECOND DRIVER APPLICATION     

2013 ROUTE MAP