REGISTRATION INFORMATION
Class: __________ Vehicle #: ___________ Member: _______________
DRIVER ENTRY
Name: ____________________________________________________
Address: __________________________________________________
City: ______________________ State: _______ Zip Code: _________
Phone #:____________________ Email Address: __________________
VEHICLE INFORMATION
Vehicle Name:
Make:___________ Model:_________________Year: ________________
Engine: ____________________ Tire Size: ________________________
Carburetion: ____________________ Suspension: __________________
Nitrous Yes ___ No ___ Fuel: _______________________________
SPONSORS
1. _____________________________________________________
2. ______________________________________________________
3. ______________________________________________________
4. ______________________________________________________
5. ______________________________________________________
RELEASE
I have read the rule book provided to me by the IMRA, and agree to abide by the rules for the safety of everyone involved in or attending the event. I being the driver and anyone involved in my pit crew hereby waive all rights for recourse against sponsoring club(s), property owners, participants, and officials or representatives of same for any damages or injury (including death) resulting from participation in this event. My pit crew and I assume all risk for loss, damage, or injury (including death) to my property and myself from any course what so ever.
Drivers Name (Print) ___________________________
Signature _____________________________________
Date __________________________________
Pit Crew (Printed Name, Signature, and Date)
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
The above named driver and pit crew members agree that there will be no alcohol in the pits until the mud race has been completed.