Online Registration Form

QUAD THIS Series
Rnd 2

Saturday October 25th, 2008

On-Line Race Entry Policy
You MUST Have A Trackside ID Number 
to Compete In This Event.
To Register Online Without An ID Number
Type "New" In the Required Fields.
TRACKSIDE ID #   

All Fields Marked with * are REQUIRED
Name*
  
Address* City*  St.*  Zip.* 
  
Phone #*  Parent's Name 
  
Email Address* 
You MUST Input your Email Address		 Birthday* 
     		Second Ph. # 
    
 
Quad Information*
Size  cc Brand Number

 

Class 1*

To race the Quad entered above in additional classes

Class 2 - Select Class

 Class 3 - Select Class Class 4 - Select Class

  

To Register The Same Rider On A Second Quad, Please Complete This Section

Quad 2 Information
Size  cc Brand Number

Quad 2 - Class 1

To race the Second Quad in additional classes

Quad 2 Class 2 - Select Class Quad 2 Class 3 - Select Class Quad 2 Class 4 - Select Class
  
Sponsors 
I, the undersigned do hereby agree to hold harmless the owner, management and track employees of VILLAGE CREEK MX PARK for any and all liability, injury or damage caused by or in any way arising out of or in connection with the facilities and services of VILLAGE CREEK MX PARK.
Signature (Rider) *   Date: *
Signature (Parent)  Date: 
Note: Parents will be required to sign MINOR RELEASE FORM at Sign-in
The signature(s) above are legal and binding signatures as governed by Texas law
Texas Electronic Signature Law
  
After Completing The Entry Form
Carefully Review All Information
Then
Click the "Submit" Button Below
Once

A Confirmation Page will be Displayed
IF All Information Was Correctly
Submitted

  

To Clear ALL INFORMATION on the Form
Click The RESET Button