Registration Form – 2018 Registration Form - 2018 Register online today to reserve your spot for the 2018 Rally on the Rocks. You really don't want to miss it! Step 1 of 4 0% Name* First Last Address* Street Address City State / Province / Region ZIP / Postal Code CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* Total $0.00 Number of Machines*12If you are bringing more than one machine, please let us know here. This is so we can accurately limit the trail numbers for the BLM.Ridings Price: $0.00 Number of Adults (12 years or older) in your party (Machine 1)1234Guided trail rides are now charged on a per person/per day basis. Children 11 and under are free.Number of childrens 11 years of age or younger. (Machine 1)*0123Please list the names and ages of each child.one name per line or separate each name with a comma.Adult 1 (Machine 1)Name* First Last Purchase Hat ($15)*No (Hat)Yes (Hat)(one size fits all)Purchase T-Shirt ($15)*No T-ShirtSmall T-ShirtMedium T-ShirtLarge T-ShirtX-Large T-ShirtXX-Large T-Shirt (+$2.00)XXX-Large T-Shirt (+$4.00)Purchase Sweatshirt ($25)*No SweatshirtSmall SweatshirtMedium SweatshirtLarge SweatshirtX-Large SweatshirtXX-Large Sweatshirt (+$2.00)XXX-Large Sweatshirt (+$4.00)Trail fundraising dinner ($15)*NoYesAdult 2 (Machine 1)Name* First Last Purchase Hat ($15)*No (Hat)Yes (Hat)(one size fits all)Purchase T-Shirt ($15)*No T-ShirtSmall T-ShirtMedium T-ShirtLarge T-ShirtX-Large T-ShirtXX-Large T-Shirt (+$2.00)XXX-Large T-Shirt (+$4.00)Purchase Sweatshirt ($25)*No SweatshirtSmall SweatshirtMedium SweatshirtLarge SweatshirtX-Large SweatshirtXX-Large Sweatshirt (+$2.00)XXX-Large Sweatshirt (+$4.00)Trail fundraising dinner ($15)*NoYesAdult 3 (Machine 1)Name* First Last Purchase Hat ($15)*No (Hat)Yes (Hat)(one size fits all)Purchase T-Shirt ($15)*No T-ShirtSmall T-ShirtMedium T-ShirtLarge T-ShirtX-Large T-ShirtXX-Large T-Shirt (+$2.00)XXX-Large T-Shirt (+$4.00)Purchase Sweatshirt ($25)*No SweatshirtSmall SweatshirtMedium SweatshirtLarge SweatshirtX-Large SweatshirtXX-Large Sweatshirt (+$2.00)XXX-Large Sweatshirt (+$4.00)Trail fundraising dinner ($15)*NoYesAdult 4 (Machine 1)Name* First Last Purchase Hat ($15)*No (Hat)Yes (Hat)(one size fits all)Purchase T-Shirt ($15)*No T-ShirtSmall T-ShirtMedium T-ShirtLarge T-ShirtX-Large T-ShirtXX-Large T-Shirt (+$2.00)XXX-Large T-Shirt (+$4.00)Purchase Sweatshirt ($25)*No SweatshirtSmall SweatshirtMedium SweatshirtLarge SweatshirtX-Large SweatshirtXX-Large Sweatshirt (+$2.00)XXX-Large Sweatshirt (+$2.00)Trail fundraising dinner ($15)*NoYesNumber of Adults (Machine 2)Number of Adults (12 years or older) in your party (Machine 2)1234Guided trail rides are now charged on a per person/per day basis. Children 11 and under are free.Number of childrens 11 years of age or younger (Machine 2)*0123Please list the names and ages of each child.one name per line or separate each name with a comma.Adult 1 (Machine 2)Name* First Last Purchase Hat ($15)*No (Hat)Yes (Hat)(one size fits all)Purchase T-Shirt ($15)*No T-ShirtSmall T-ShirtMedium T-ShirtLarge T-ShirtX-Large T-ShirtXX-Large T-Shirt (+$2.00)XXX-Large T-Shirt (+$4.00)Purchase Sweatshirt ($25)*No SweatshirtSmall SweatshirtMedium SweatshirtLarge SweatshirtX-Large SweatshirtXX-Large Sweatshirt (+$2.00)XXX-Large Sweatshirt (+$4.00)Trail fundraising dinner ($15)*NoYesAdult 2 (Machine 2)Name* First Last Purchase Hat ($15)*No (Hat)Yes (Hat)(one size fits all)Purchase T-Shirt ($15)*No T-ShirtSmall T-ShirtMedium T-ShirtLarge T-ShirtX-Large T-ShirtXX-Large T-Shirt (+$2.00)XXX-Large T-Shirt (+$4.00)Purchase Sweatshirt ($25)*No SweatshirtSmall SweatshirtMedium SweatshirtLarge SweatshirtX-Large SweatshirtXX-Large Sweatshirt (+$2.00)XXX-Large Sweatshirt (+$4.00)Trail fundraising dinner ($15)*NoYesAdult 3 (Machine 2)Name* First Last Purchase Hat ($15)*No (Hat)Yes (Hat)(one size fits all)Purchase T-Shirt ($15)*No T-ShirtSmall T-ShirtMedium T-ShirtLarge T-ShirtX-Large T-ShirtXX-Large T-Shirt (+$2.00)XXX-Large T-Shirt (+$4.00)Purchase Sweatshirt ($25)*No SweatshirtSmall SweatshirtMedium SweatshirtLarge SweatshirtX-Large SweatshirtXX-Large Sweatshirt (+$2.00)XXX-Large Sweatshirt (+$4.00)Trail fundraising dinner ($15)*NoYesAdult 4 (Machine 2)Name* First Last Purchase Hat ($15)*No (Hat)Yes (Hat)(one size fits all)Purchase T-Shirt ($15)*No T-ShirtSmall T-ShirtMedium T-ShirtLarge T-ShirtX-Large T-ShirtXX-Large T-Shirt (+$2.00)XXX-Large T-Shirt (+$4.00)Purchase Sweatshirt ($25)*No SweatshirtSmall SweatshirtMedium SweatshirtLarge SweatshirtX-Large SweatshirtXX-Large Sweatshirt (+$2.00)XXX-Large Sweatshirt (+$4.00)Trail fundraising dinner ($15)*NoYes Choose the trails you would like to attend at the rally for each day. Be sure to check the description on the right (hover over the trail names) to be sure your machine meets the required specs. To see a complete list of trail descriptions and their difficulty ratings click here. T=Trailer required to get to trail head. All trail selections this year are FINAL. There will be NO trail changing this year. Day 1 - May 15th-Tuesday*Not Riding This Day2-Chicken Corners (11 spots left)2-Picture Frame Arch (0 spots left)3-Gemini Bridges (T) (19 spots left)3-Kane Creek (0 spots left)3-Porcupine Rim (16 spots left)4-Fins and Things (0 spots left)4-Fins and Things 2 (1 spots left)6-Hells Revenge (0 spots left)6-Hells Revenge 2 (18 spots left)7-Steelbender (5 spots left)7-Poison Spider (T) (19 spots left)8-Moab Rim (1 spots left)9-Behind the Rocks (23 spots left)Day 2 - May 16th-Wednesday*Not Riding This Day2-Jackson Hole (12 spots left)3-Kane Creek (0 spots left)3-Porcupine Rim (3 spots left)4-Fins and Things (5 spots left)4-Fins and Things 2 (23 spots left)5-Top of the World (T) (8 spots left)5-Seven Mile Rim (T) (0 spots left)6-Hells Revenge (0 spots left)6-Hells Revenge 2 (2 spots left)6-Gold Bar/Gold Spike (T) (8 spots left)7-Steelbender (8 spots left)7-Poison Spider (T) (13 spots left)8-Moab Rim (5 spots left)9-Cliffhanger (12 spots left)Day 3-May 17th, Thursday*Not Riding This Day2-Chicken Corners (5 spots left)3-Kane Creek (10 spots left)3-Picture Frame Arch (T) (17 spots left)3-Porcupine Rim (6 spots left)4-Fins and Things (Ladies Ride) (25 spots left)4-Fins and Things 2 (7 spots left)5-3D/Hidden Canyon (T) (17 spots left)6-Hells Revenge (0 spots left)6-Hells Revenge 2 (1 spots left)6-Gold Bar/Gold Spike (T) (0 spots left)7-Steelbender (0 spots left)7-Poison Spider (T) (0 spots left)7-Top of the World (T) (11 spots left)7-Strike Ravine (T) (11 spots left)8-Moab Rim (7 spots left)8-Behind the Rocks (T) (0 spots left)9-Cliffhanger (0 spots left)Day 4-May 18th, Friday*Not Riding This Day3-Porcupine Rim (6 spots left)3-Kane Creek (0 spots left)4-Fins and Things (7 spots left)4-Fins and Things 2 (5 spots left)5-Seven Mile Rim (T) (0 spots left)6-Hells Revenge (0 spots left)6-Hells Revenge 2 (1 spots left)6-Gold Bar/Gold Spike (T) (0 spots left)7-Steelbender (0 spots left)7-Poison Spider (T) (0 spots left)7-Metal Masher (T) (0 spots left)8-Moab Rim (6 spots left)9-Behind the Rocks (7 spots left)9-Cliffhanger (0 spots left)Day 5-May 19th, Saturday*Not Riding This Day3-Porcupine Rim (14 spots left)3-Kane Creek (2 spots left)3-Picture Frame Arch (0 spots left)4-Fins and Things (15 spots left)4-Fins and Things 2 (22 spots left)6-Hells Revenge (0 spots left)6-Hells Revenge 2 (16 spots left)6-Gold Bar/Gold Spike (T) (4 spots left)7-Steelbender (0 spots left)7-Poison Spider (T) (0 spots left)7-Seven Mile Rim (T) (19 spots left)7-Metal Masher (T) (18 spots left)8-Behind the Rocks (T) (14 spots left)8-Moab Rim (11 spots left)9-Cliffhanger (0 spots left)RidingsDiscount (Machine 1)Discount to any vehicles carrying more than 2 passengersDiscount (Machine 2)Discount to any vehicles carrying more than 2 passengersTotal $0.00 What is your annual income?*Please SelectPrefer not to answer$25,000 to $50,000$50,000 to $75,000$75,000 to $100,000$100,000+What is your age bracket?*Please selectPrefer not to answer18-1920-2930-3940-4950-5960-6970+What Brand Machine do you own? If you own more than one, pick your favorite.*Prefer not to answerArctic CatCan AmHondaKawasakiKymcoPolarisYamahaIs this your first time attending Rally on the Rocks?*YesNoHow did you hear about Rally on the Rocks?*What state/province/territory will you travel from to attend the Rally?*Please Select One-- UNITED STATES --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific-- CANADA --AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonEmergency Contact InfoPlease list someone not at the Rally.Name* First Last Phone*Email Waiver and Release of Liability WAIVER AND RELEASE OF LIABILITY In consideration of the undersigned participant to be allowed entrance into the Discount Tire Rally on the Rocks event held May 15-19, 2018, the undersigned, on his/her own behalf and on behalf of his/her respective legal representatives, heirs, next of kin, etc. hereby acknowledges and agrees as follows: 1. Risk. I understand that participation in the Discount Tire Rally on the Rocks event involves many risks and dangers. Such risks and dangers include but are not limited to, serious bodily injury, permanent disability, death, and/or property damage which could result in severe social and economic losses and/or damages. 2. Waiver and Release. I hereby fully and forever discharge, release, waive, and covenant not to sue Rally on the Rocks, LLC and its respective agents, directors, trail guides, affiliates, employees, officers, trail sponsors, members, successors, and assigns, from any and all liability affecting or related to the undersigned’s participation in this event and I do so on my own behalf and as well as on behalf of my personal representatives, heirs, and next of kin for any and all claims, causes of action, demands, losses, or damages associated with any injury to the undersigned or my property, or death while traveling to or from, participating in, or otherwise pursuing any activity associated with or in any way related to, the Rally on the Rocks event. 3. Minor Children. If I am signing this document to allow a minor child to participate in the Discount Tire Rally on the Rocks event, I represent that I have full legal authority to do so and I acknowledge that I am assuming on behalf of my minor child all risk of personal injury, death, or disability that may result to him/her from participation in the event to the same extent as set forth in the preceding paragraphs. I indemnify the released parties from any and all bills, lawsuits, liabilities, claims, obligations, costs, damages, or expenses that may result from such minor’s participation in this event. 4. Insurance. I represent and warrant that I have adequate medical or other insurance to cover and pay for any possible injury that may occur to me and my minor children (if applicable). To the extent the insurance does not pay for all costs or damages, I also agree to pay for any and all costs and expenses of such injury or damage to myself or my minor child (if applicable). 5. Understanding. I have read this Waiver and Release of Liability, fully understand its terms, understand that I may have given up substantial rights by signing it, including the right to bring a lawsuit or claim against the released parties and have signed it freely and voluntarily on my own behalf and on behalf of any minor child named herein without any inducement, representation, assurance, or guarantee being made to me and intend by signature to the complete and unconditional release of all liability to the greatest extent allowed by law. 6. Electronic Signature. I hereby acknowledge (1) that this document is electronically signed in accordance with Utah Code Ann. 46-4-201 and (2) that this document is valid and may be enforced in the same manner as a hand-signed document that exists in physical form. I also expressly acknowledge the validity of the electronic signature appended to this document, which was made by me on the date this form was electronically submitted. I further agree that I have knowingly and explicitly waived any right to claim this document is invalid or is unenforceable based on (1) the fact that this document exists in electronic form or (2) the fact that this document is signed electronically. 7. Severability. If any party of this waiver is found to be void or unenforceable, the remaining portions thereof shall remain in full force and effect. DATED: 03/14/2018 Rules & Regulations* By checking this box I have read, understand, and agree to the Rules & Regutions for Rally on the Rocks All Rules & Regulations can be found by selecting the info tab at the top of any page. Signature 1* Signature 2* Signature 3* Signature 4* Signature 5*Signature 6*Signature 7*Signature 8*Total Ridings Price: $0.00 Total RidingsDiscount Ridings Price: $0.00 Discount to any vehicles carrying more than 2 passengersHats TotalT-shirt TotalTotal SweatshirtDinner TotalTotal $0.00 Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name All trail selections this year are final. There will be no trail changing at the event this year. NameThis field is for validation purposes and should be left unchanged. Spread the love