Somernites Soap Box Derby 13-20

Somernites Soap Box Derby presented by:

Somerset Pulaski Co Chamber of Commerce, Somernites Cruise, Readers to Leaders Story Book Trails, & The Urban Stillhouse
Saturday, June 27, 2026
Age Group 13-20 yr old
Racer Name*

First NameLast Name
Racer Age*

MonthDayYear
Date
Parent/Guardian Name (if under 18)

First NameLast Name
Racer Phone Number*
Please enter a valid phone number.
Racer Email*
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Racer Address*

Street Address

Street Address Line 2

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Postal / Zip Code
Racer T-Shirt Size*

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Please provide details about your derby car design.*
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Minor Waiver Release Form

Required if racer is under 18 years old
I, named above (parent/guardian) hereby certify I am the legal parent or guardian of named racer above being under the age of 18 years old. (son/daughter/ward). As such parent/guardian, I agree to my son, daughter, and/or ward of being permitted with intention to participate in the Somernites Soap Box Derby that will be held on Main Street in Somerset, KY, and inconsideration of the benefits received by myself and my child and/or ward as a result of said Somernites Soap Box Derby, I,together with my heirs, executors, administrators, and assigns, hereby release, waive, and forever discharge and covenant not to sue the Somernites Soap Box Derby, its sponsors; Somerset Pulaski Co Chamber of Commerce, SomernitesCruise, Readers to Leaders Story Book Trails and the Urban Stillhouse, and/or all of their officers, agents, members, employees, full or part-time, insurers, lessees, lessors, and associates of any status whatsoever, all for the purpose herein referred to as Releasees, from all liability to me, my heirs, executors, administrators, and assigns for all loss or damage, and any claim or damage therefore, on account of injury to my person, child, and/or ward, or property or resulting in my death, whether caused by the negligence of Releasees or otherwise while I or my child/ward is utilizing the above described race track facilities and/or observing any Soap Box Derby and/or related event being held on MainStreet in Somerset, KY. I hereby further agree to indemnify and to hold forever harmless the said Releasees from any and all claims, loss, liability, damage, or cost Releasees may incur due to my and or my child/ward’s presence at the Somernites Soap Box Derby while participating in and/or observing said Somernites Soap Box Derby races and/or events. I hereby assume all responsibility for and risk of bodily injury, death, or property damage due to any act or omission of Releasees while so I, or my child/ward, is participating in and/or observing said Somernites Soap Box Derby races and/or events. I expressly agree that this release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State of Kentucky and that if any portion thereof is held invalid, it is agreed that the balance shall, not withstanding, continue in full force and legal effect. I, being of lawful age, as legal parent or guardian, in consideration of, and/or my child/ward, to participate in and/or observe Soap Box Derby races and/or events in the Somernites Soap Box Derby release and forever discharge Releasees, their heirs, administrators, and executors of and from any and every claim, demand, action, of whatsoever kind or nature, either in law or in equity arising from or by reason of any bodily injury or personal injuries known or unknown, death, and/or property damage which may occur as a result of my, and/or my child/ward’s participation in and/or observation of Soap Box Derby races and/or events on Main Street in Somerset, KY any activity in connection therewith, whether by negligence or not. I, being of lawful age, as legal parent or guardian, in consideration of, and/or my child/ward, to participate in and/or observe Soap Box Derby races and/or events in the Somernites Soap Box Derby and its sponsors its sponsors; Somerset Pulaski Co Chamber of Commerce, Somernites Cruise, Readers to Leaders Story Book Trails and the Urban Stillhouse to use photographs or videos of named racer above, (son/daughter/ward) for use in promotion of Somernites Soap Box Derby and future marketing.
Signature*

Racer Waiver & Release Form
I, named above (parent/guardian) hereby certify I am the legal parent or guardian of named racer above being under the age of 18 years old. (son/daughter/ward). As such parent/guardian, I agree to my son, daughter, and/or ward of being permitted with intention to participate in the Somernites Soap Box Derby that will be held on Main Street in Somerset, KY, and inconsideration of the benefits received by myself and my child and/or ward as a result of said Somernites Soap Box Derby, I,together with my heirs, executors, administrators, and assigns, hereby release, waive, and forever discharge and covenant not to sue the Somernites Soap Box Derby, its sponsors; Somerset Pulaski Co Chamber of Commerce, SomernitesCruise, Readers to Leaders Story Book Trails and the Urban Stillhouse, and/or all of their officers, agents, members, employees, full or part-time, insurers, lessees, lessors, and associates of any status whatsoever, all for the purpose herein referred to as Releasees, from all liability to me, my heirs, executors, administrators, and assigns for all loss or damage, and any claim or damage therefore, on account of injury to my person, child, and/or ward, or property or resulting in my death, whether caused by the negligence of Releasees or otherwise while I or my child/ward is utilizing the above described race track facilities and/or observing any Soap Box Derby and/or related event being held on MainStreet in Somerset, KY. I hereby further agree to indemnify and to hold forever harmless the said Releasees from any and all claims, loss, liability, damage, or cost Releasees may incur due to my and or my child/ward’s presence at the Somernites Soap Box Derby while participating in and/or observing said Somernites Soap Box Derby races and/or events. I hereby assume all responsibility for and risk of bodily injury, death, or property damage due to any act or omission of Releasees while so I, or my child/ward, is participating in and/or observing said Somernites Soap Box Derby races and/or events. I expressly agree that this release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State of Kentucky and that if any portion thereof is held invalid, it is agreed that the balance shall, not withstanding, continue in full force and legal effect. I, being of lawful age, as legal parent or guardian, in consideration of, and/or my child/ward, to participate in and/or observe Soap Box Derby races and/or events in the Somernites Soap Box Derby release and forever discharge Releasees, their heirs, administrators, and executors of and from any and every claim, demand, action, of whatsoever kind or nature, either in law or in equity arising from or by reason of any bodily injury or personal injuries known or unknown, death, and/or property damage which may occur as a result of my, and/or my child/ward’s participation in and/or observation of Soap Box Derby races and/or events on Main Street in Somerset, KY any activity in connection therewith, whether by negligence or not. I, being of lawful age, as legal parent or guardian, in consideration of, and/or my child/ward, to participate in and/or observe Soap Box Derby races and/or events in the Somernites Soap Box Derby and its sponsors its sponsors; Somerset Pulaski Co Chamber of Commerce, Somernites Cruise, Readers to Leaders Story Book Trails and the Urban Stillhouse to use photographs or videos of named racer above, (son/daughter/ward) for use in promotion of Somernites Soap Box Derby and future marketing.
Signature*

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Event Registration Fee
Payment for the event itself (includes 1 free t-shirt)

$35.00 Quantity

Additional T-Shirts
Additional T-Shirts only available by Pre-Order

$15.00 QuantitySize

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Somernites Soap Box Derby presented by:

Saturday, June 27, 2026

Age Group 13-20 yr old

Minor Waiver Release Form

Racer Waiver & Release Form