2012 Kart Registration Form

 Please Print this form and Type or legibly print all answers to fill in all blank spaces completely with appropriate information to ensure that all your points will be posted to your name. Thank you.

Driver Name:

Last:

First

 

Date:

Address:

Street Address

Suite #

City

State

ZIP

Phone Number:

Date of Birth:

________/_________/_________

Email Address:

Kart Information

Class

Restricted Box    Box Stock    125/250     Open/500cc       Adult Cage Clone        Adult Clone

Circle one

Kart Color:

Kart Number:

I do hereby agree, by signing this English Creek Speedway entry form, that I will abide by all rules and regulations set forth by English Creek Speedway, including but not limited to the following:

1. I have or will have familiarized myself with all the English Creek Speedway rules and regulations, including kart specifications and safety rules. And I specifically agree to abide by all English Creek Speedway rules.                               

 2. I agree that I shall be the sole spokesperson for myself, the kart owner, and the crew in all matters pertaining to compliance with the rules and regulations, and I agree and understand that I am responsible for the conduct of my crew.                        

 3. I agree and understand that by submitting my race kart for various technical and safety inspections, I certify that the race kart meets all the rules and regulations for participation in English Creek Speedway rules and regulations, and I understand violation of various rules can result in a fine, suspension, and loss of all track points.                                                                

4. I agree to appropriately use all required stickers, decals and patches, and I understand that failure to do so will result in loss of points and forfeiture of all money and awards for the event.                                                                                   

5. I agree that all decisions of English Creek Speedway race officials or track officials regarding the interpretation and application of the English Creek Speedway rules and the scoring of points shall be non-litigable. I further covenant and agree that I will not initiate any type of legal action against English Creek Speedway to challenge such decisions, to seek monetary damages, to seek injunctive relief or to seek any other kind of legal remedy. I understand that if I pursue any such legal action which violates this provision, then I expressly agree to reimburse English Creek Speedway for all of its attorney’s fees and costs in defending against such legal action.                                                                                                                                      

6. I also agree to release all advertising and promotional rights to my name, kart and likeness to English Creek Speedway and its sponsors.                                                                                                                                               

7. I understand that all points, awards, and money earned will be paid to the driver.                                                      

 8. I further understand that there is no express or implied warranty of safety resulting from publication or compliance with the English Creek Speedway rules and that they are intended as a guide for the conduct of the sport and are in no way a guarantee against injury or death to participants, spectators or others.                                                                                        

9. I further agree that all required forms and documents have been provided to English Creek Speedway including but not limited to a notarized Minor’s Release.

COMPETITOR.S SIGNATURE _________________________________________________DATE:___________________                                                            (signature of Parent or Guardian required if competitor is a minor.)                                                         EMERGENCY NAME & PHONE  ___________________________________________________

  Mail to: MLC Motorsports 2005 North Lincoln St. Knoxville, Iowa 50138   

*Registration Fees –$25.00 Per Kart must be paid on or Before First RACE 2012 *this is a annual fee- Thank you

 

  
 
     
     
 

2012 NATIONALS Registration Form

Please Print this form and Type or legibly print all answers to fill in all blank spaces completely with appropriate information to ensure that all your points will be posted to your name. Thank you.

Driver Name:

 

 

 

Date:

 

Address:

 

 

 

Street Address

Suite #

 

 

 

 

 

City

State

ZIP

Phone Number:

 

Date of Birth:

________/_________/_________

Email Address:

 

Kart/Lawn Mower Information

Class

Restricted Box               Box Stock            125             Open/500cc           Lawn Mower

 

                  Circle one

 

 

Kart  Color:

Kart Number:

 

 I do hereby agree, by signing this English Creek Speedway entry form, that I will abide by all rules and regulations set forth by

English Creek Speedway, including but not limited to the following:

1. I have or will have familiarized myself with all the English Creek Speedway rules and regulations, including kart specifications and safety rules. And I specifically agree to abide by all English Creek Speedway rules.

2. I agree that I shall be the sole spokesperson for myself, the kart owner, and the crew in all matters pertaining to compliance with the rules and regulations, and I agree and understand that I am responsible for the conduct of my crew.

3. I agree and understand that by submitting my race kart for various technical and safety inspections, I certify that the race kart meets all

the rules and regulations for participation in English Creek Speedway rules and regulations, and I understand violation of various rules can

result in a fine, suspension, and loss of all track points.

4. I agree to appropriately use all required stickers, decals and patches, and I understand that failure to do so will result in loss of points and

forfeiture of all money and awards for the event.

5. I agree that all decisions of English Creek Speedway race officials or track officials regarding the interpretation and application of the

English Creek Speedway rules and the scoring of points shall be non-litigable. I further covenant and agree that I will not initiate any type of legal action against English Creek Speedway to challenge such decisions, to seek monetary damages, to seek injunctive relief or to seek any other kind of legal

remedy. I understand that if I pursue any such legal action which violates this provision, then I expressly agree to reimburse English Creek Speedway for all of its attorney’s fees and costs in defending against such legal action.

6. I also agree to release all advertising and promotional rights to my name, kart and likeness to English Creek Speedway and its sponsors.

7. I understand that all points, awards, and money earned will be paid to the driver.

8. I further understand that there is no express or implied warranty of safety resulting from publication or compliance with the English Creek Speedway rules and that they are intended as a guide for the conduct of the sport and are in no way a guarantee against injury or death to participants, spectators or others.

9. I further agree that all required forms and documents have been provided to English Creek Speedway including but not limited to a notarized Minor’s Release.

COMPETITOR.S SIGNATURE _________________________________________________________ DATE_______________________ (signature of Parent or Guardian required if competitor is a minor.)

EMERGENCY NAME & PHONE___________________________________________________________________________________

 Fax or Mail to:MLC Motorsports 2005 North Lincoln St.Knoxville, Iowa 50138 Fax: 641-842-4539

*$50.00 Entry Fee for the Event