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 Antique Tractor Parade. A second tractor may NOT be used. All rules and regulations apply to the alternate driver. A registration fee of $15.00 is required, which includes 2 name plaques, breakfast, and a morning and afternoon snack break.

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 Driver’s Name________________________________________________________________

Have you been on the Great Franklin County Tractor Ride before? Yes____ No_____ What Year?_____

A pancake breakfast will be served from 6:00 till 9:00 A.M. at North Iowa Cooperative in Thornton. The KLMJ Antique Tractor Parade will start in Thornton at North Iowa Cooperative and go through Meservey, Alexander, Latimer, Hampton, Beeds Lake, Chapin, Sheffield, and back to Thornton. The ride will stop for a one-hour tractor show during Hampton’s Annual Summerfest Celebration in Band Shell Park. A morning break is planned in Alexander, with a surprise afternoon break.

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 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 Antique Tractor Parade

Alternate Driver Safety Pledge

I, _______________________________, hereby pledge to hold safety as the highest priority on the KLMJ 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 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 REARVIEW MIRRORS AND A SLOW MOVING VEHICLE SIGN ARE REQUIRED.

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 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 kqcrtraffic@mchsi.com.

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