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"Grattan G-Fair" SATCAR® FORMULA STREET® FALL SERIES ENTRY FORM
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CAR |
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NAME
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YEAR
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ADDRESS
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MAKE
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CITY,
STATE, ZIP
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MODEL
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PHONE
HOME
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COLOR
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PHONE
WORK
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CAR NO. PREFERENCE | |||
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FAX
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NUMBERS ON CAR? | YES NO | ||
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E-MAIL
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DO YOU HAVE AN AMB TRANSPONDER? YES NO | |||
| SATCAR MEMBER NO. | IF YES, TRANSPONDER NUMBER | |||
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COMPETITION LICENSE NO. |
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EXPERIENCE
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HELMET
REQUIREMENT
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Helmets with a Snell rating of M95 or SA95 or newer are acceptable (SA is preferable). If the car has a roll bar or roll cage, only SA95 or newer helmets are acceptable. |
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ENTRY
FEES
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ENTRY
FOR
SATURDAY
SUNDAY
BOTH DAYS
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DRIVING
SCHOOL ENTRY
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$300.00 one day $470.00 both days | ||
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LAPPING/PRACTICE
ENTRY
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$275.00 one day $425.00 both days | ||
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RACE
ENTRY
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$300.00 one day $470.00 both days | ||
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LUNCH
TIME TOURING
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$45.00 one day $80.00 both days | ||
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HIGH MILE REWARD
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-$10 -$15 -$20 | ||
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TRANSPONDER
RENTAL (REQUIRED FOR RACE GROUP IF YOU DO NOT OWN A TRANSPONDER)
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$35.00 one day $55.00 both days | ||
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LATE
ENTRY (ENTRY AFTER SEPTEMBER 13TH)
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$50.00 | ||
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AMOUNT ENCLOSED (US$ ONLY) |
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QUALIFIER
DEPOSIT (NON REFUNDABLE)
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$50.00 | ||
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OR:
TOTAL ENTRY AMOUNT
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PAYMENT
OPTIONS
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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. |
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CREDIT CARD # EXPIRATION DATE / |
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SIGNATURE __________________________________________ |
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REFUND
POLICY
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Cancellation refunds will be subject to the following conditions: 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. |
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EMERGENCY
INFORMATION
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PERSON
TO NOTIFY IN CASE OF AN EMERGENCY
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ADDRESS
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RELATIONSHIP
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CITY,
STATE, ZIP
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CELL
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PHONE
HOME
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E-MAIL
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PHONE
WORK
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WILL THIS PERSON BE AT THE TRACK? YES NO | |||
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VEHICLE
INSURANCE INFORMATION
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IS
THIS VEHICLE INSURED FOR LIABILITY AND MEDICAL COVERAGE ON THE DATE OF
THE EVENT?
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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 Grattan Raceway Park 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 Grattan Raceway Park.
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 | ___________ | |
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| OWNER SIGNATURE (if different) | ___________________________________ | DATE | ___________ | |
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PLEASE PRINT AND SEND COMPLETED ENTRIES TO: SATCAR®, 5N775 Campton Ridge, St. Charles, IL 60175
For Office Use:
