I,___________________________ , who plans to build a Soap Box Derby racer to be entered in 
the Pikes Peak Acura Soap Box Derby Race being held in Colorado Springs, Colorado on June 
22, 2008, herby certify that I will build my racer in full compliance with the 2008 Official 
(Masters / Super Stock / Stock) Division Rules.

I,____________________________ , (parent/guardian) hereby grant permission for my son/
daughter/ward to enter the Pikes Peak Acura Soap Box Derby Race and in the event that he or 
she is adjudged the winner of the Pikes Peak Acura Soap Box Derby Race, to participate in the
All-American Soap Box Derby, (Masters / Super Stock / Stock Division), on July 26, 2008 in Akron, Ohio.

Further, I understand and agree that as a prerequisite to competing in the Pikes Peak Acura 
Soap Box Derby, Colorado Springs, Colorado, that my son/daughter/ward together with his/her 
car, shall undergo and pass an inspection conducted at Colorado Springs, Colorado by 
officials of the Pikes Peak Acura Soap Box Derby. I further understand and agree that such 
inspection shall be conducted using the manner and methods deemed appropriate by the 
officials in their sole discretion, to determine compliance with the rules, spirit and 
specifications applicable to the Masters / Super Stock / Stock Division and that the decisions 
of the officials regarding qualification and disqualification and compliance with the rules, 
spirit and specification applicable to the Masters / Super Stock / Stock Division shall be final
and binding upon me, my son/daughter/ward and all other parties.

Finally, as such parent or guardian, in consideration of the benefits received as a result 
of the participation herein, and for the mutual benefits received by myself and my child 
and the other participants herein, I hereby assume all risks associated with this activity 
and specifically waive and release any and all claims, rights, causes of action, demands or 
otherwise, whether for personal injuries, property damages, or any other loss, damages or 
expenses which I as a parent/guardian and/or son, daughter or ward may have against the 
Pikes Peak Acura Soap Box Derby, International Soap Box Derby, Inc., and any and all 
sponsors, agents, employees, full or part time, or associates of any status whatsoever 
arising from or in any manner related to my son’s, daughter’s or ward’s participation in 
the Pikes Peak Acura Soap Box Derby, the All-American Soap Box Derby and/or any activities 
incidental or related thereto.

Signature of Parent/Guardian 

Print Name

Address

Date