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To be a member of the Master’s Miata Club, please print this form, read the waiver below, sign underneath it stating that you understand and agree to it:

That I, my heirs, executors, administrators, and personal representatives do not hold liable the Master’s Miata Club, its officers, agents, servant or employees whether acting officially or not, arising out of affiliation for any actions, complaints, proceedings, claims, demands, injuries, damages, actions or causes of action which arise wholly or partially due to the negligence of any kind as a result in an organized rally or scheduled event or meeting organized by the Master’s Miata Club.

I hereby expressly forever release and discharge the Master’s Miata Club, vendors invited by the Master’s Miata Club, their agents and employees from all such claims, demands, injuries, damages, actions or cause of action, including those for negligence, arising out of or related to any loss, damage, or injury, including death, that may be sustained by me or my property by reason of my permission to participate in the Master’s Miata Club.

Signature(s):___________________________________________________________

Then, fill out the rest of the form:

Name(s):______________________________________________________________

Street:________________________________________________________________

City:________________________________________ State:______ Zip:___________

Home Phone:________________ Email Address:_______________________________

Year of car:_______ Exterior Color:____________________ Interior Color:_________

Then mail it along with a check for $10 to:


Treasurer
Master’s Miata Club
P.O. Box 6746
Aiken, SC 29804