Circle:
MINI THUNDER CAR
KART
Number Requested 1st
Choice_______ 2nd
Choice________3rd Choice _______
Driver Name:________________________________________ Phone:____________
Soc Sec #________________________
Mailing Address : City
____________________________State ZIP_____________
Driver Date of Birth:_____________ Years Racing Experience:
Who is responsible
for earnings (IRS 1099 Form)?
If not the driver fill in Social Security # of person responsible:____________________
Mailing Address:
City:
__________State
ZIP
IF YOU WANT
SPONSORS ANNOUNCED YOU MUST CLEARLY PRINT THE INFORMATION ON A
· I fully agree to abide by the rules and regulations of the Mottville Speedway. I acknowledge that I have received a copy of the rules and I fully understand that all decisions of track officials are final!
· I understand, accept and agree that no ambulance or medical staff is on site.
· I accept emergency equipment and staff as adequate.
· I fully understand that I am racing at my own risk.
· I understand that if I am disqualified for rough driving, unsportsmanlike conduct, an illegal car, drinking in the pits, speeding in the pits or any other form of disqualification that I will be paid nothing for the night!
· I fully understand that the TIMING TOWER is off limits to all drivers, crew member, car owners during the racing program and that if I go to the timing tower I will suspended and/or fined as determined by track officials. I understand stock cars must finish feature to be paid.
· I understand that anti-freeze can not be in my car until after Oct 15! and I understand that this registration can’t be transferred to another division without an additional payment and can not be sold.
· I understand that that if I leave any used tires on track property the fine is $10 per tire and I agree to pay it!.
· I fully understand that racing is by its very nature a very dangerous sport and I agree to hold totally blameless the Mottville Speedway, its owners and track officials for any and all injuries suffered by me.
· In the event of my death I direct my estate to take no legal action against the Mottville Speedway, its owners or track officials.
·
I understand that if I do not race at the Mottville Speedway for a
period of 3 Weeks my number will no longer be reserved. Any car left at the
Mottville Speedway 2 weeks without racing will be disposed of.$50 fee!
I HAVE READ AND I
FULLY UNDERSTAND THIS AGREEMENT AND AGREE TO ABIDE BY IT!
Driver Signature Date Print Name
Car Owner Signature Date Print Name
If driver is under 18 years of age I, the parent or legal guardian of the driver, by signing below agree that I have read the above agreement and will abide by it and that I have signed the MINOR RELEASE AGREEMENT for the season and that I assume all responsibility for any and all injuries suffered by the above named minor. I fully understand that track does not promote the driving of race cars/karts by minors but will allow it based on my assumption of the risk.
Parent/Legal Guardian Signature Date Print Name