ALL DRIVERS MUST COMPLETE INFORMATION BELOW

Size: px

Start display at page:

Download "ALL DRIVERS MUST COMPLETE INFORMATION BELOW"

Sheila Ramsey
5 years ago
Views:

Mailing Address: PO Box 322 Lancaster, NY 14086 Phone: 716-759-6818 Website: LancasterNationalSpeedway.

DIFFERENT) ADDRESS CITY/ STATE/ ZIP BEST PHONE NUMBER TO CONTACT YOU E-MAIL Date of Birth MONTH DAY YEAR EMERGENCY CONTACT EMERGENCY PHONE The person registered as car owner, will receive

1 Mailing Address: PO Box 322 Lancaster, NY Phone: Website: LancasterNationalSpeedway.com 2018 STOCK CAR REGISTRATION, MEMBERSHIP & NUMBER APPLICATION PLEASE PRINT LEGIBLY ALL DRIVERS MUST COMPLETE INFORMATION BELOW APPLICANT NAME PLEASE PRINT LEGIBLY CAR OWNER NAME (IF DIFFERENT) ADDRESS CITY/ STATE/ ZIP BEST PHONE NUMBER TO CONTACT YOU Date of Birth MONTH DAY YEAR EMERGENCY CONTACT EMERGENCY PHONE The person registered as car owner, will receive year-end tax form (1099) for any money won by the registered car. No exceptions can or will be made. THIS PART MUST BE FULLY COMPLETED OWNER SOC. SEC. # OR TAX ID # Completed W-9 on file as of ARE YOU INCORPORATED YES NO I am: [ ] Driver [ ] Car Owner [ ] Crew Member Car # Division

2 BEFORE AFTER DRIVER/CAR OWNER FEES 3/17/2018 3/17/2018 PIT PAD #( s) $100 $125 [ ] Sportsman (SST Modified) $50 $60 [ ] PIT PAD [ ] Street Stock $40 $50 [ ] PIT PAD [ ] Four Cylinder $25 $30 [ ] PIT PAD [ ] Crew Member $25 $30 N/A TOTAL $ DATE CASH CHECK # MASTERCARD / VISA (Circle One) Card # CVC Code Expiration NOTE: PIT PASS PURCHASE PRICE FOR EACH SATURDAY NIGHT DIVISION IS $25 FOR MEMBERS / $35 FOR NON-MEMBERS Better HALF Pass (Sportsman, Street Stock, Four Cylinder Only): I designate to be on the list for half price grandstand admission for all regular events. This does not include the SuperModified show or US Open. **** TO PARTICPATE FOR POINT FUND AWARDS, A COMPETITOR MUST REGISTER BY July 1, 2017 To Owners, Drivers and Crew Members: YOU are a big part of Lancaster s resurgence the past three seasons with great racing, increased car counts and attendance. In 2018, we are again looking to move forward and keep improving what was achieved by fans in the stands and stars in the cars. As we ready to race at OUR track of Lancaster National Speedway, remember there are others looking at you as racers, role models and champions. Please keep that in mind when you race and how you behave on and off the track, in person and online. Race smart, race safe and most of all - have fun. Tim Packman Track President Lancaster National Speedway & Dragway #Stability #Loyalty Social Media Policy By signing below I hearby understand making disparaging, threatening and/or negative comments about the track, track management and officials, fellow racers and partners can lead to fines, escalated fines and/or disqualification from events. Complaints and concerns are to be shared DIRECTLY with management and officials and NOT in a public manner via Social Media avenues.

3 IN CONSIDERATION of being permitted to compete, officiate, observe, work for, or participate in any way in the EVENTS or Being permitted to enter for any purpose any RESTRICTED AREA (defined as any area requiring special authorization, Credentials, or permission to enter any area to which admission by the general public is restricted or prohibited), I THE UNDERSIGNED, for myself, my personal representatives, heirs, and next of kin: 1. Am a driver, mechanic, pit crew or other team member, or other participant engaged in racing, and I am not participating in the EVENTS or entering the RESTRICTED AREA for recreational purposes. 2. Acknowledge, agree, and represent that I have or will immediately upon entering any of such RESTRICTED AREAS, and will contin- uously thereafter, inspect the RESTICTED AREAS which I enter, and I further agree and warrant that, if at any time, I am in or about RESTRICTED AREAS and I feel anything to be unsafe, I will immediately advise the officials of such and if necessary will leave that RESTRICTED AREA. 3. HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE THE PROMOTERS, PARTICIPANTS, RACING ASSOCIATIONS SANCTIONING ORGANIZATIONS OR ANY SUBDIVISION THEREOF, TRACK OPERATORS, SPONSORS, ADVERTISERS, OWNERS AND LESSEES OF PREMISES USED TO CONDUCT THE EVENTS, 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 EVENTS and each of them, their directors, officers, agents and employees, all for the purposes Herein referred to as Releasees, FROM ALL LIABILITY TO THE UNDERSIGNED, my personal representatives, assigns, heirs, and next Of kin FOR ANY AND ALL LOSS OR DAMAGE, AND ANY CLAIM OR DEMANDS THEREFORE ON ACCOUNT OF INJURY TO THE PERSON OR PROPERTY OR RESULTING IN DEATH OF THE UNDERSIGNED ARISING OUT OF OR RELATED TO THE EVENTS, WHETHER CAUSED BY THE RELEASEES OR OTHERWISE. 4. HEREBY AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS THE RELEASEES AND EACH OF THEM FROM ANY LOSS, LIABILITY,DAMAGE, OR COST they may incur arising out of or related to the EVENTS WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES OR OTHERWISE. HEREBY ASSUME FULL RESPONSIBILITY FOR ANY RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE arising Out of or related to the EVENTS whether caused by the NEGLIGENCE OF RELEASEES or otherwise. HEREBY acknowledge that THE ACTIVITIES OF THE EVENTS ARE VERY DANGEROUS and involve the risk of serious injury And/or death and/or property damage. I, THE UNDERSIGNED, also expressly acknowledge that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES. HEREBY agree that this Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement extends to all acts of negligence By the Releasees, INCLUDING NEGLIGENT RESCUE OPERATIONS and is intended to be as broad and inclusive as is permitted by The laws of the Province or State in which the Event(s) is/are conducted and that if any portion thereof is held invalid, it is agreed that the Balance shall, notwithstanding, continue in full legal force and effect. I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW. By my signature, I agree to abide by all rules as stated in the Lancaster National Speedway 2015 rulebook. I fully understand and have read the pit waiver information sheet & insurance regulations which I must sign each time I enter the pit area. I also agree to accept all official s decisions as final, with the understanding that all officials have the right to deviate from written specifications, if needed. With my signature I waive my rights to sue. NO EXCEPTIONS CAN OR WILL BE MADE. Print Name Signature Date Witnessed By

Ogden Cycle Association Membership Agreement

Date: Ogden Cycle Association Membership Agreement Membership Type: (mark all that apply) Single Family Non-Wor king Charter Life Cash / Check # Amount Paid $ Receipt # New Member / Annual Renewal I agree