2008 PIR STARS OPEN ENTRY FORM

Tucson Raceway Park
2008 PIR Stars Open Entry Form

Car Number is: (please enter choices)             

Car #  1st______________ 2nd________________ 3rd _______________           

Make of Car                                       Year                  

Model                               Chassis_______________________     

Driver’s Name :(Print)                                                                       

SSN ____________________________________                                        
 
Address:                                                                                          

City/State/Zip:   ___________________________                

 Date of Birth:                                        

Minor Release Form on File (Under 18)     YES                   NO __________                      
 
Home Phone #                                        

Work Phone #                                          

Cell Phone # ____________________                   

Fax #                                                             

E-Mail Address:   ________________________________

 In Case of Emergency Notify  (Print)                                                            

Phone # ______________________________                                  

In consideration of  Tucson Raceway Parks approval of this Car entry  application and for the opportunity to participate in the    2008 Stars Open I agree to the following:

1.  ACKNOWLEDGEMENT AND AGREEMENT TO ABIDE BY RULES.  I acknowledge that I have read and understand all terms and provisions in the official Rules, and all special rules published by the promoter  of this facility and I will abide by the terms and provisions as they may be amended from time to time, and by  all  decisions by TRP and  it’s officials interpreting and applying them.
2.  ADVERTISING AND PROMOTION RELEASE.  TRP, it’s duly authorized agents and assigns, may use my name, likeness and
performance, including photographs, images and sounds of  me and/or any vehicle(s) with respect to which I compete in this event,

in any way, medium or material (including but not limited to broadcasts by and through television, cable television, radio, pay-per-view, closed circuit television, satellite signal, digital signal, film productions, audiotape productions, transmissions over the Internet, public and private online services authorized by TRP, and the like) for promoting, advertising, or reporting any TRP event before, during and after such Event, and I do hereby relinquish to TRP all rights thereto for such purposes; provided, however, that except as specified otherwise herein, I shall retain the exclusive use of my name, picture and likeness in connection with product endorsements and the sale of products, services, concessions and merchandise.
3.  PERSONAL INJURY AND PROPERTY DAMAGE RELEASE.  I hereby release and waive any and all claims pursuant to the RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT in this Application.

I hereby state that all the above information is true and accurate to the best of my knowledge.  Any misrepresentation of the above may result in a fine and/or suspension from the facility.

Signature                                                                                                            

Date ______________________                                    

Make Checks Payable:  Tucson Raceway Park    or VISA/ MC is accepted
Mail to: Tucson Raceway Park 8110 S. Houghton Rd  #158-125 - Tucson, AZ  85747

Credit Card # ____________________

Expiration Date ____________CID # ___________       

Name on Credit Card ____________________

Signature ___________________________