2019 OWNER / DRIVER / CREW APPLICATIONS

Size: px

Start display at page:

Download "2019 OWNER / DRIVER / CREW APPLICATIONS"

Karen Mitchell
5 years ago
Views:

Application Summary: 2019 Owner License: The fee for a 2019 Modified Racing Series Owners license is $250.00 (two-hundred fifty dollars).

1 Application Summary: 2019 Owner License: The fee for a 2019 Modified Racing Series Owners license is $ (two-hundred fifty dollars). An Owner s License gives the owner rights to a car number until 12/31/19, and will be awarded all prize and point fund monies. All 2019 Modified Owner Licenses include a (1)owner and (1)driver per application. Owners with more than (1) driver must notify additional driver(s) about licensing fees. All Modified Racing Series Teams must run Modified Racing Series roof sticker and a-post stickers to be eligible for event purse and point fund monies. Any team without a Modified Racing Series roof and a-post stickers, will have 10% of purse money deducted. A team representative MUST be present at the season ending banquet to receive point money and trophy. (top fifteen in points awarded) Owners may not sell or transfer owners rights and or car number without prior written consent from the Modified Driver s License: The fee for a 2019 Modified Racing Series Drivers license is $ (one-hundred dollars). All drivers must hold a valid 2019 Modified Racing Series drivers license for competition at any Modified sanctioned event. Only licensed drivers are eligible to attempt to qualify for an event and be awarded drivers points. Crew Member License: (Required) The fee for a 2019 Modified Racing Series Crew Member license is $10.00 (ten dollars). Crew Member License is for identification purposes. A Crew Member License makes crew member eligible for possible admission discounts and other contingency programs available throughout the season. Release and Indemnity Agreement: 1. I understand that applications when accepted will cause me to be issued a owner / driver / crew license, which is not an insurance policy and does not give me any right other than to establish my eligibility to procure upon on payment of a fee, a pit pass and track provided competitor insurance limited to activities at that event for a Modified sanctioned event. 2. I further agree to purchase a pit pass and competitor insurance before entering the pit area or engaging in competition and in consideration of the foregoing, I do hereby FOREVER RELEASE, REMISE and FOREV- ER DISCHARGE Modified, and all officers, directors, agents, employees, the owners and lessees of premises of which events are conducted, the owners, competitors, sponsors and manufacturers of all racing equipment upon the premises, from all liability claims, actions and possible causes of action whatsoever that may accrue to me or my heirs, next of kin and personal representatives from every and any loss, damage and injury (including death) that may be sustained by my person and/or property while in about, en route into and out of premises of a sanctioned racing event or any premises where Modified Racing 3. By signing a 2019 Modified Racing Series Owner / Driver / Crew Application, I acknowledge that I have read the entire form and understand its content. The owner / driver / crew license is issued pursuant to and governed by the 2019 Modified Racing Series Rule book and Modified The licensed member assigns use of their name(s) and likeness and race car presented for competition to the Modified Racing Series Inc. for use in any medium or material for the purpose of promoting, advertising, recording and reporting related to the Modified

2 Application Summary continued- Page 2 Release and Indemnity Agreement continued: 4. By submitting an official entry blank and/or taking part in any activity relating to a Modified Racing Series event, the person agrees to abide by the decisions of Modified Racing Series officials and Modified relating to the event or any matters arising out of the event, and agrees that such decisions are final, nonappealable and non-litigable. Such a member further agrees to inspect his/her race car and all related equipment, the race facilities and all related safety equipment as well as conditions of the race track, and that member voluntarily assumes the risk of, and no claims for damages against Modified Racing Series, Inc., the promoter or their employees, the directors, officials, employees, or deemed agents by reason of damage to the car, or injury, or death of the driver, the pit crew or any other person. All members assume full responsibility for any and all injuries sustained, including death and all property damage, anytime they are in the racing areas or en-route there to or there from. Each member acknowledges that the members spouse and next-of-kin have been advised that the member understands the high risk of serious injury or death which may result from racing, and that the member solely assumes all such risks. Owner s Signature: Car #: ***** Please sign and return this page with your 2019 application ******

3 2019 OWNER / DRIVER APPLICATION Car Owner Information Car #: Alternate Car #: Car Owner s Name: Car Owner s Social Security # or Federal Id #: 2019 Owner Application Fee: $ (two-hundred dollars) includes (1) owner and (1) driver Owner is purchasing rights to the car number until 12/31/19. After 2/1/19Deadline $ * ALL PURSE AND POINT FUND MONIES ARE PAID TO CAR OWNER LISTED ABOVE * Driver Information Driver s (legal) Name: Driver s Social Security # or Federal Id #: Driver s Date of Birth: Team/Driver Website: I understand that this application when accepted will cause me to be issued a owner / driver license, which is not an insurance policy and does not give me any right other than to establish my eligibility to procure upon on payment of a fee, a pit pass and track provided competitor insurance limited to activities at that event for a Modified sanctioned event. I further agree to purchase a pit pass and competitor insurance before entering the pit area or engaging in competition and in consideration of the foregoing, I do hereby FOREVER RELEASE, REMISE and FOREVER DISCHARGE Modified Racing Series Inc., and all officers, directors, agents, employees, the owners and lessees of premises of which events are conducted, the owners, competitors, sponsors and manufacturers of all racing equipment upon the premises, from all liability claims, actions and possible causes of action whatsoever that may accrue to me or my heirs, next of kin and personal representatives from every and any loss, damage and injury (including death) that may be sustained by my person and/or property while in about, en route into and out of premises of a sanctioned racing event or any premises where Modified Racing By signing this 2019 Modified Racing Series Owner / Driver Application, I acknowledge that I have read the entire form and understand its content. This owner / driver license is issued pursuant to and governed by the 2019 Modified Racing Series Inc. Rule book. The licensed member assigns use of their name(s) and likeness and race car presented for competition to the Modified for use in any medium or material for the purpose of promoting, advertising, recording and reporting related to the Modified Checks may be made payable to: Modified, For additional information please call or log on to All information on 2019 Application is for Modified, internal use only. Car Owner Signature: Driver Signature:

4 Crew Member License: (Required) The fee for a 2019 Modified Racing Series Crew Member license is $10.00 (ten dollars) each. Crew Member License is for identification purposes. A Crew Member License makes crew member eligible for possible admission discounts and other contingency programs available throughout the season. CAR# ( Please Print Names ) (1) Crew Member Name: Position: (2) Crew Member Name: Position: (3) Crew Member Name: Position: (4) Crew Member Name: Position: (5) Crew Member Name: Position: (6) Crew Member Name: Position: (7) Crew Member Name: Position: (8) Crew Member Name: Position: (9) Crew Member Name: Position: (10)Crew Member Name: Position: Release and Indemnity Agreement: 1. I understand that applications when accepted will cause me to be issued a owner / driver / crew license, which is not an insurance policy and does not give me any right other than to establish my eligibility to procure upon on payment of a fee, a pit pass and track provided competitor insurance limited to activities at that event for a Modified sanctioned event. 2. I further agree to purchase a pit pass and competitor insurance before entering the pit area or engaging in competition and in consideration of the foregoing, I do hereby FOREVER RELEASE, REMISE and FOREV- ER DISCHARGE Modified, and all officers, directors, agents, employees, the owners and lessees of premises of which events are conducted, the owners, competitors, sponsors and manufacturers of all racing equipment upon the premises, from all liability claims, actions and possible causes of action whatsoever that may accrue to me or my heirs, next of kin and personal representatives from every and any loss, damage and injury (including death) that may be sustained by my person and/or property while in about, en route into and out of premises of a sanctioned racing event or any premises where Modified Racing 3. By signing a 2019 Modified Racing Series Owner / Driver / Crew Application, I acknowledge that I have read the entire form and understand its content. The owner / driver / crew license is issued pursuant to and governed by the 2019 Modified Racing Series Rule book and Modified The licensed member assigns use of their name(s) and likeness and race car presented for competition to the Modified Racing Series Inc. for use in any medium or material for the purpose of promoting, advertising, recording and reporting related to the Modified

5 2019 ADDITIONAL DRIVER APPLICATION Additional Driver Information Car #: Alternate Car #: Driver s (legal) Name: Driver s Social Security # or Federal Id #: Driver s Date of Birth: Team/Driver Website: 2019 Driver Application Fee: $ (one-hundred dollars). * ALL PURSE AND POINT FUND MONIES ARE PAID TO THE REGISTERED CAR OWNER* I understand that this application when accepted will cause me to be issued a owner / driver license, which is not an insurance policy and does not give me any right other than to establish my eligibility to procure upon on payment of a fee, a pit pass and track provided competitor insurance limited to activities at that event for a Modified sanctioned event. I further agree to purchase a pit pass and competitor insurance before entering the pit area or engaging in competition and in consideration of the foregoing, I do hereby FOREVER RELEASE, REMISE and FOREVER DISCHARGE Modified Racing Series Inc., and all officers, directors, agents, employees, the owners and lessees of premises of which events are conducted, the owners, competitors, sponsors and manufacturers of all racing equipment upon the premises, from all liability claims, actions and possible causes of action whatsoever that may accrue to me or my heirs, next of kin and personal representatives from every and any loss, damage and injury (including death) that may be sustained by my person and/or property while in about, en route into and out of premises of a sanctioned racing event or any premises where Modified Racing By signing this 2019 Modified Racing Series Owner / Driver Application, I acknowledge that I have read the entire form and understand its content. This owner / driver license is issued pursuant to and governed by the 2018 Modified Racing Series Inc. Rule book. The licensed member assigns use of their name(s) and likeness and race car presented for competition to the Modified for use in any medium or material for the purpose of promoting, advertising, recording and reporting related to the Modified Driver Signature: Checks may be made payable to: Modified, For additional information please call or log on to All information on 2019 Application is for Modified, internal use only.

SCCA Rally/Solo Release and Waiver Guidelines

RISK MANAGEMENT I. Introduction SCCA Rally/Solo Release and Waiver Guidelines These guidelines are intended to provide basic information regarding release and waiver procedures for ALL non-club or SCCA