FOR OFFICE USE ONLY
Entry Fee:
Membership Fee:
Total:
Rider Name:
Parent or Guardian:
Address:
City:
Age:
DOB:
Event Date:
Event Location:
State:
Zip:
Email:
Phone:
Classes are considered Short Track unless marked with TT. TT is only run at certain events.
General Classes $10 Registration | 100% Divided to Top 3
Class
Number
Brand
50cc MC
65cc MC
85cc MC
Super Mini MC
Pit Bike
Powder Puff MC
Youth MC
250 cc MC
450cc MC
Novice MC
Veteran MC
Super Mini MC TT
Novice MC TT
Class
Number
Brand
60cc ATV
90cc ATV STOCK
90cc ATV Pro-Mod
Knobby ATV
200cc ATV
300cc ATV
Powder-puff ATV
400cc ATV
450 cc ATV
Novice ATV
Veteran MC
90cc ATV Pro-Mod TT
Novice ATV TT
Pro-AM Classes $20 Registration | 100% Divided to Top 3
Class
Number
Brand
Pro-AM MC
Pro-AM MC TT
Class
Number
Brand
Pro-AM ATV
Pro-AM ATV TT
Pro Classes $30 Registration | 100% Divided to Top 3
Class
Number
Pro MC
Pro MC TT
Brand
Class
Number
Brand
Pro ATV
Pro ATV TT
Release of Liability:
I hereby release, waive, discharge, and covenant not to sue the promoters, participants, racing associations, sanctioning organizations or
any subdivision thereof, track operators, track owners, officials, owners, riders, pit crews, rescue personnel, any persons in any restricted
area, sponsors, advertisers, owners and lessees of premises used to conduct the event(s), premises and event inspectors, surveyors,
underwriters, consultants and others who give recommendations, directions, or instructions or engage in risk evaluation or loss control
activities regarding the premises or event(s) and each of them, their directors, officers, agents and employees from all liability for any loss
or damage, and any claim or demands therefore on account of injury resulting to the person or property or resulting in death arising out
of or related to the series event(s) whether caused by neglegance of myself or otherwise. I also acknowledge that motor vehicle
mishaps, in competition or otherwise, can result in injury or death. To my fullest extend I understand that minors without parental
consent or supervision should never use motor vehicles. I fully understand that there is no rider medical insurance provided!
Signature of Participant:
Date:
If participant is under 18 years old, his/her parent or legal guardian must sign this form!
Signature of Parent/Guardian:
Date:
Staff Initial: