2012 Reserved # Form
Print out form, fill out & mail to:
Trail-way Speedway,
100 Speedway Lane, Hanover, PA 17331
When your number is processed, you can visit 2012 rosters listed on our website and see that you're in the proper class.
*IMPORTANT !! - ALL DRIVERS THAT RETURN THIS FORM COMPLETED BEFORE THEIR FIRST SCHEDULED RACE, WILL BE ELIGIBLE TO DRAW A SECOND PILL FOR THEIR INITIAL LINE UP.*
1. All Race Drivers are required to
reserve their racing number when entering any of the regular classes for
the first time during the racing season. Visiting classes may not have
to fill one out. This number is reserved for the individual driver, not
the car. B) NO CHARGE FOR : * POWDER PUFF * FIGURE 8 * JUNK CAR * LATE MODELS
PLEASE SEND IN PAGES 2 AND 3. YOU ONLY NEED TO SEND IN PAGE 4 IF YOU ARE UNDER 18 YEARS OLD. EXAMPLE, I WOULD LIKE TO RESERVE CAR NUMBER __99___IN CLASS_600___: #_______ 1ST CLASS ___________, #_______ 2ND CLASS ___________,#_____ 3RD CLASS __________ 1. CHECK BOX TO ACKNOWLEDGE THAT I WILL READ THE 2012 RULES and MUST BE PRESENT AT THE BANQUET TO RECEIVE ANY YEAR END AWARD. 2. CHECK BOX IF YOU ALREADY OWN A RACECEIVER. TO RETAIN PREVIOUS
YEAR RACE CAR NUMBER, EACH RESERVED NUMBER MUST
2. DRIVER NAME__________________________SS #__________________PHONE_______________ ADDRESS___________________________________________________AGE___________________
5. E-MAIL ______________________________@_________________________________ PERSON RESPONSIBLE FOR RECEIVING RACE WINNINGS
4. RECEIVER'S NAME_________________________________________PHONE_______________ ADDRESS__________________________________________________________________________ CITY____________________________________________STATE________ZIP CODE_________ 5. E-MAIL ______________________________@_________________________________
SOCIAL SECURITY # OR TAX
ID # OF PERSON RESPONSIBLE LIST 1 MAIN SPONSOR 1. ____________________________________TOWN/STATE/ZIP_______________________________ Office Use Only: Rec. Date_______/_______ Cash or Ck#________ Int _________ Other Info ___________________________________ Sent Date ____/____ |
RELEASE FORM, MUST BE SIGNED (A) This Is A RACE LIABILITY RELEASE For Applicant
Named On Reverse Side Of This Form In consideration of being granted
an opportunity to race at any or all races sponsored by TRAIL-WAY SPORTS
CLUB, INC. DBA/ MOTORAMA EVENTS, AND/OR TRAIL-WAY SPEEDWAY, I intend
to be legally bound hereby: ........................................................................ *** MUST BE WITNESSED BELOW!! *** ________________________________ ______/______/_______ ____________________________
(TO BE COMPLETED IF APPLICANT IS UNDER 18 YEARS OF AGE) I am the parent or legal guardian of (4)____________________________________________________
|
| (5) SUBSCRIBED
AND SWORN TO BEFORE ME: THIS______ DAY OF____________________, 20______ SIGNATURE OF PERSON ADMINISTERING OATH __________________________________________________ S |
(6) I HAVE HEREUNTO
AFFIXED MY HAND & SEAL THIS______ DAY OF ________________, 20______
PRINT PARENT OR GUARDIAN'S SIGNATURE ___________________________________________________ PARENT OR GUARDIAN'S SIGNATURE (7)_________________________________________________ |