2008 Race of Champions Dart Asphalt
Modified Tour Membership Application
Applicant Name: ___________________________________________ Car #:
_____________
(car numbers will not be
assigned until roc office receives receipt of paid membership application)
Applicant
Address: _____________________________________________________________
(please print and fill
out completely)
__________________________Zip Code:
______________ S.S #:
_______-______-______
Birth Date: ____/____/____ Phone
Numbers: (h) __________________ (w) _________________
Cell Phone Number: ___________________ Email Address: __________________________
Driver Website: ______________________ Other Car # Choices: _____________________
Car Owner:
____________________________ S.S
#: _______ - _______ - _______
Owner Address:
_____________________________________________ Zip Code: __________
Phone Numbers: (h) ____________________ (w) __________________ (c)
___________________
THE PERSON THAT ANY PURSE OR
POINT FUND MONIES ARE PAID TO SHOULD BE LISTED
ABOVE AS
CAR OWNER WITH COMPLETE INFORMATION PROVIDED.
Every driver competing in one or all events must file a tour membership
application. A Race of Champions Membership
Card will be sent to each driver for identification purposes.
Crew Members may purchase a discounted membership making them eligible for possible
admission discounts and other contingency programs. All members will have one vote for regional and
overall “crew member of the year” awards.
Please Check One: Crew Membership: $35 __________ (includes all races)
Driver
Membership:
1 Event Temp: $50 ______
Season Membership: $125 ______
IN CONSIDERATION of the
acceptance of this Race of Champions Modified Tour Membership Form, I for
myself, my heirs, next of kin, personal representatives and assigns, FOREVER
RELEASE, REMISE and FOREVER DISCHARGE and AGREE TO HOLD HARMLESS and INDEMNIFY
the promoters presenting races or other events, the owners (lessors) of the
premises at which these events are held, the participants, theron, and the
owners, sponsors and manufacturers of all racing equipment used in any of these
events, the officers, directors, agents, employees and servants of all of them,
including officials and Race of Champions Modified Tour members, of and from
all liability, claims, action and of possible causes of action whatsoever. Including negligence of any of the
foregoing, that may accrue to me or my heirs, next of kin and personal
representatives from every and any loss, damage and injury, including death,
that may be sustained by my person and property while in or about and enroute
into and out of any Race of Champions Modified Tour event.
By Signing this 2008
Race of Champions Modified Tour membership Form I acknowledge that I have read
the entire form and understand its contents.
The Race of Champions Modified Tour has consent to use driver name and
likeness for promotional and souvenir materials. This Race of Champions Membership may be
revoked at any time for failure to adhere to tour rules, implied or
assessed.
Applicant Signature: _____________________________ Date
Signed: _______________
Checks may be made
payable to: Race of Champions,