Avenal Sand Drags

We Suport Our Troops

                                                                                                  Car #___________
PLEASE PRINT CLEARLY

NAME____________________________PHONE________________
ADDRESS_______________________________________________
CITY________________________STATE______ZIP____________
E-MAIL_________________________________________________
VEHICLE:
MAKE_____________MODEL___________YEAR______COLOR___________
                                                                          
____ TOP FUEL                                                                                    $200.00____                
____ TOP ALCOHOL                                                                             $200.00____                
____ TOP ELIMINATOR (This class runs on a 2.95 index and is heads up) $200.00____

____ PRO 1-4                                                                                       $75.00____

____ PRO INDEX  (This class runs on a 3.95 index and is heads up)         $150.00____
          
____ PRO BIKE 1-2                                                                              $75.00____

____ SPORTSMAN 1-4                                                                         $  50.00____
  
____ SPORT BIKE 1-2                                                                          $  50.00____

____ KIDS BRACKETS                                                                         $  35.00____              

             RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
The UNDERSIGNED hereby releases, waives, discharges and covenants not to sue the promoters, participants, racing
associations, sanctioning organizations or any subdivision thereof, track operators, track owners, officials, vehicle owners,
drivers, pit crews, rescue personnel, any persons in any RESTRICTED AREA, promoters, sponsors, advertisers, owners and
lessees of premises used used to conduct the EVENT(S), premises and event inspectors, surveyors, underwriters, consultants
and others how grive recommendations, directions, or instructions or engage in risk evaluation or loss control activities
regarding the premises or EVENT(S) and each of them, their directors, officers, agents, and employees, all for the purposes
herein referred to as “releases”, from all LIABILITY TO THE UNDERSIGNED, his personal representatives, assigns, heirs, and
next of kin FOR ANY AND ALL LOSS OR DAMAGE AND ANY CLAIM OR DEMANDS THEREFOR ON ACCOUNT OF INJURY
TO THE PERSON OR PROPERTY OR RESULTING IN DEATH OF THE  UNDERSIGNED ARISING OUT OF OR RELATED
TO THE EVENT(S), WEATHER CAUSED BY THE NEGLIGENCE OF THE RELEASES OR OTHERWISE. THE
UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the Releases and each of them
from any loss, liability, damage, or cost they may incur arising out of or related to the EVENT(S) whether caused by the
negligence of the release or otherwise. THE UNDERSIGNED hereby assumes full responsibility for any risk of bodily injury,
death or property damage arising out of or related to the EVENT(S) weather caused by the NEGLIGENCE OF RELEASES or
otherwise.  
I have read this Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement, fully understand its
terms, understand that I have given up substantial rights by signing it and have signed it freely and voluntarily without
any inducement, assurance, or guarantee being made to me and extend my signature to be a complete and
unconditional release of all liability to the greatest extent allowed by law.
                                  I FULLY UNDERSTAND THAT THERE IS NO INSURANCE PROVIDED.
                                               I UNDERSTAND DRAG RACING IS DANGEROUS.


Signature: _____________________________ Date: _________________________

                                                      RACE CHECK LIST

                 X = OK                                        N = NOT SAFE


LUG BOLTS                  __________                 FIREWALL                     __________

FRAME                          __________                BATTERY                       __________

SUSPENSION                __________                FUEL TANK                     __________

ROLL CAGE                  __________               COTTER PINS                 __________

AIR CLEANER                __________               SAFETY BLANKET         __________

DRIVE LINE LOOP         __________                FIRE EXTINGUISHER      __________

STEERING                     __________                SEAT BELTS                 __________

EXHAUST                      __________                 HELMET                        __________

SCATTERSHIELD          __________                BRAKES                         __________

         


REMARKS & COMMENTS:
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INSPECTOR’S SIGNATURE                                        DATE