KIWANIS OF WEST SEATTLE 

2nd ANNUAL CHARITY MOTORCYCLE POKER 
RUN, BIKE & CLASSIC CAR SHOW  
 

PROCEEDS OF THIS EVENT WILL SUPPORT 
CANCER RESEARCH AT CHILDREN’S HOSPITAL 

Date:  May 14th, 2011 
 

Location:   40th Ave SW & SW Alaska St, West Seattle 98126 
       (lot adjacent to Howden‐Kennedy Funeral Home) 
Pre‐registration:  $25.00 per Bike ‐ $30.00 with Passenger 
Day‐Of Registration:   $30.00 per Bike ‐ $35.00 with Passenger 
Lunch Only:    $10.00 per person 
(Entry fee includes Bar‐B‐Q, entry into bike show, water/snacks in route, and entry into Prize 
drawings) 
 
Click on this
Pre‐registration cut‐off date is May 9, 2011.  K-Icon to
Time:      Registration/Check‐in    8:30 am – 9:30 am  link to our
     Ride (Poker Run)    9:30 am ‐ 1 pm  Donations
     Bar‐B‐Que      1:30 pm ‐ 3 pm  page.
   

Additional Poker Hands can be purchased on the day of the event. 

Submit one (1) entry form per participant.  Event is open to the general public; entries are 
limited & subject to the discretion of the Kiwanis of WS.   Event will be held Rain or Shine.  
Because this event is a fundraising drive for the Seattle Children’s Hospital and the youth in 
our community, there can be no refunds.  
  

Contact the Kiwanis at westseattlekiwanis@live.com 
westseattlekiwanis@live.com with any questions. 
 

Bike Show 2:30 PM 
Prizes for Best Hand, Worst Hand & Additional 
Categories! 
 

(Winners of other categories to be chosen by majority vote from 
attendees) 

Sponsors and Route Points are:

Kiwanis of West Seattle – 21st Century Scholarship
2nd Annual Charity Motorcycle Rally and Bike & Classic Car Show to benefit the Seattle Children’s Hospital

Waiver and Release – all riders and passengers must complete:

(Please read and sign below)

I wish to participate in the Kiwanis of West Seattle “2nd Annual Charity Motorcycle Rally and Bike Show” on May 14,
2011. I understand that while participating in this event, I will be using public parks, streets and facilities where many
hazards exist and I am aware of and appreciate the risks that may result. I am also aware that accidents may occur
during this event which could result in serious injury or death. I am voluntarily participating in this event with
knowledge of the dangers involved and I agree to accept all risks of injury or death.

IN CONSIDERATION FOR BEING PERMITTED TO PARTICIPATE IN THIS EVENT, I AGREE TO

ASSUME ALL RISKS AND TO RELEASE, HOLD HARMLESS AND COVENANT NOT TO SUE KIWANIS
OF WEST SEATTLE, THE 21ST CENTURY SCHOLARSHIP FUND AND ANY DESIGNATED
BENEFICIARIES, SPONSORS, INCLUDING, BUT NOT LIMITED TO, THE DEPARTMENT OF
TRANSPORTATION AND AFFILIATED ORGANIZATIONS AND ALL THEIR RESPECTIVE
DIRECTORS, OFFICERS, AGENTS, EMPLOYEES AND MEMBERS (COLLECTIVELY, “THE
RELEASEES”), FOR ANY CLAIM, LOSS OR LIABILITY THAT I MAY HAVE ARISING OUT OF MY
PARTICIPATION IN THE EVENT, INCLUDING BODILY INJURY, DEATH OR PROPERTY DAMAGE,
WHETHER CAUSED BY NEGLIGENCE OR CARELESSNESS OF THE RELEASEES OR OTHERWISE.

I intend by the Waiver and Release to release in advance, and to waive my rights and to discharge all of the releases
from all claims, losses or liabilities for death, bodily injury or property damage that I may have, or which may hereafter
accrue to me, as a result of my participation in this event, even though that liability may arise from negligence or
carelessness on the part of the releases, from dangerous or defective property or equipment owned, maintained or
controlled by them or because of their possible liability without fault. I understand and agree that this Waiver and
Release is binding on my heirs, assigns and legal representatives. I am physically capable of completing this event. If I
am aware of or under treatment for any physical infirmity, ailment or illness, my medical care provider knows of and
has approved my participation in this event. I will maintain personal health insurance while participating in the event. I
acknowledge that I and I alone, is solely responsible for my personal health and safety, and the personal property I
bring with me. I understand that all donations processed by the Kiwanis of West Seattle – 21st Century Scholarship
Account are non-refundable and non-transferable, even if I do not participate in the event. I authorize Kiwanis of West
Seattle to use photos taken during the event as they deem appropriate.

I have carefully read this Waiver and Release and fully understand its contents. I am aware that by signing this Waiver
and Release, I am waiving legal rights and knowing this, I sign it of my own free will. Please circle the activity that
will best describes your participation in this event:

Rider Passenger General Participant Volunteer

Print Full Name Bike Model License Plate #

Signature Date