PERFORMANCE DRIVING

- FROM STREET TO TRACK


SATCAR FORMULA STREET SPRINT RACES ENTRY FORM

GINGERMAN RACEWAY - SOUTH HAVEN, MI

August 15, September 12, October 10, 2009

DRIVER

 

CAR

NAME
 
YEAR
ADDRESS
 
MAKE
CITY, STATE, ZIP
 
MODEL
PHONE HOME
 
COLOR
PHONE WORK
  CAR NO. PREFERENCE
FAX
  NUMBERS ON CAR? YES NO
E-MAIL
  DO YOU HAVE AN AMB TRANSPONDER? YES NO
SATCAR MEMBER NO.   IF YES, TRANSPONDER NUMBER

COMPETITION LICENSE NO.

 
EXPERIENCE
 

HELMET REQUIREMENT

Helmets with a Snell rating of M2000 or SA2000 or newer are acceptable
(SA is preferable). 

If the car has a roll bar or roll cage, only SA2000 or newer helmets are acceptable.

ENTRY FEES
AUGUST 15, 2009 - RACE
  $200.00
LAPPING OR DRIVERS SCHOOL
  $150.00
SEPTEMBER 12, 2009 - RACE
  $200.00
LAPPING OR DRIVERS SCHOOL
  $150.00
OCTOBER 10, 2009 - RACE
  $200.00
LAPPING OR DRIVERS SCHOOL
  $150.00
     
AMOUNT ENCLOSED (US$ ONLY)
TOTAL ENTRY AMOUNT
PAYMENT OPTIONS

Payment can be made by check, money order, credit card or Paypal. Fees are due at least 7 days prior to the scheduled event. Entries will be accepted as received - enter early, enter often.

If paying by check or money order, make payable to: SATCAR and mail to the address below.

If paying by Paypal, please transfer funds to our Paypal account klfischer-satcar@msn.com

Credit card payments can be made by VISA or Mastercard.

CREDIT CARD # EXPIRATION DATE /

   

SIGNATURE __________________________________________


REFUND POLICY

Cancellation refunds will be subject to the following terms:

7-15 days prior to the event
- If another entrant is waiting - full amount less 25%
- If no other entrant is waiting - full amount less 50%

Less than 7 days prior to the event - no refunds
No Shows will not receive a refund.

If the event is cancelled by SATCAR, full refunds will be
issued

 


EMERGENCY INFORMATION
PERSON TO NOTIFY IN CASE OF AN EMERGENCY
ADDRESS
 
RELATIONSHIP
CITY, STATE, ZIP
 
CELL
PHONE HOME
 
E-MAIL
PHONE WORK
  WILL THIS PERSON BE AT THE TRACK? YES NO
VEHICLE INSURANCE INFORMATION
IS THIS VEHICLE INSURED FOR LIABILITY AND MEDICAL COVERAGE ON THE DATE OF THE EVENT?
YES NO
VEHICLE VIN
INSURANCE COMPANY
POLICY NUMBER LIABILITY LIMITS

 


ALL ENTRANTS PLEASE READ AND SIGN

NOTE: SATCAR RESERVES THE RIGHT TO ACCEPT OR REJECT ANY ENTRY. Receipt of an event entry form, invitation, or advertisement, or the submission of an entry form with payment DOES NOT constitute acceptance by SATCAR. SATCAR further reserves the right to classify any entrant as it deems appropriate.

RACE TRACK ACTIVITIES CAN BE HAZARDOUS. A race track environment can be a hazardous location during driving and non-driving activities. Vehicles are constantly moving, both on and off the track. The constant motion can result in serious injury or death to persons and in damage to vehicles.

In submitting an event application, the Entrant:

1. Agrees to accept responsibility for the safety of him/herself, their guests, and their crew members. Entrant further agrees to hold harmless by either him/herself, their assigns, and heirs, all personnel and representatives of SATCAR and GingerMan Raceway and their respective assigns and heirs.

2. Agrees to accept responsibility for all vehicles brought to the track, at all times during the event.

3. Agrees that the Entrant and all owners, drivers, and crew personnel will cooperate with SATCAR, its Officials, and any representatives of GingerMan Raceway.

4. Agrees to abide by the SATCAR bylaws, the Rules of Competition (ROC), any Supplementary Rules of the Event (SRE) pertaining to the running of this event, and all track regulations.

5. Acknowledges that sanctions or penalties may be imposed by SATCAR Officials, and agrees, without reservation, to all consequences, sanctions, or penalties imposed, resulting from any violation of the ROC, SRE or track regulations.

6. Renounces the right to any recourse to arbitration or tribunal except as provided for in the SATCAR bylaws.

PUBLICITY RELEASE: The entrant and/or driver hereby agrees to permit SATCAR the use of their voice and likeness for news, publicity, promotion, and feature use, including radio, TV and printed or electronic media and further stipulates that no prior agreement with any sponsor or other person is in conflict with this agreement.

I HEREBY STATE THAT I HAVE READ AND UNDERSTAND THE CONTENTS OF THIS ENTRY APPLICATION AND THAT BY PLACING MY SIGNATURE BELOW, I ACCEPT ALL OF THE CONDITIONS SET FORTH IN IT AND AGREE TO ITS TERMS AND CONDITIONS. I FURTHER STATE THAT ALL INFORMATION PROVIDED ON THIS ENTRY IS ACCURATE AND TRUTHFUL TO THE BEST OF MY KNOWLEDGE.

DRIVER SIGNATURE ___________________________________   DATE ___________

PRINT NAME

___________________________________      
OWNER SIGNATURE (if different) ___________________________________   DATE ___________

PRINT NAME

___________________________________    

PLEASE PRINT AND SEND COMPLETED ENTRIES TO: SATCAR, 5N775 Campton Ridge, St. Charles, IL 60175

For Office Use:

 

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