Driver Information Primary Phone * Secondary Phone Driver Experience * Car Information
please complete as much as you know when registering; information can be amended as necessary
Car # Request, 2nd Choice * Car Make/ Model * Primary Sponsor Associate Sponsors If there is historical or other significance with this car, please indicate here: Is the Driver the Car Owner? * If No, Who Is the Car Owner? Emergency Contact Information (for Driver) Phone * Relationship * Registration Fee Payment Annual Fee (for 2021) *
$ 50.00 Credit Card Information (Visa, MasterCard, American Express) * Confirm Name on Credit Card *
A receipt for payment will be sent to the email address in the Driver Information section.
Agreement Checkboxes *
• PAGE 2, FUN. FAIR. SAFE SECTION PAGE 13, SECTION 14 (QUALIFYING, LINEUPS & RACE PROCEDURES) SUB SECTION B; PAGE 14, SECTION 15 (COMPETITION) SUB SECTION A & E.
Checkboxes (copy) *
By submitting this form it is understood and agreed by the applicant that the driver's name and likeness may be used by Hot Rod Classics Association (hereafter referred to as 'HRCA') to promote the series and/or its events. HRCA reserves the right to decline registration of any applicant for safety or other reasons. The applicant also understands and agrees that all decisions made by HRCA or designated representatives shall be final and without recourse. In the event that the applicant is disqualified as a result of racing efforts, it shall be without restitution of any part of the fee paid in connection with this application and further, the applicant waives any and all rights or claims to any purse or bonus money. The applicant further waives any and all rights for themselves, their agents and assigns, to institute any action, suits or proceeding, whether at law, or any other action against HRCA and its officers, directors, agents and employees for any and all, manner or action and actions, cause and causes of actions, suits, damages, and claims that the applicant and their heirs, successors, assigns may have not, or at any time in the future may have, arising in any manner of HRCA promoted events. The applicant understands and agrees that this release constitutes a waiver of any and all claims for personal injury, breach of contract, and any other loss of damage except as expressly provided herein. Furthermore, the applicant acknowledges the support of racing fans, sponsors, the media, and the Promoter and agrees they will compete on a best effort basis; and agree to notify HRCA if they will not be competing in an event, realizing time is of the essence in this matter. The applicant acknowledges this application fee is non-refundable, except if the application is declined by HRCA, in which case a full refund will be issued to the original payment method.
Registration Form Submitted By *
herein known as the 'applicant'; must be the driver or an authorized legal representative
Complete Registration Application
This form and payment will be processed when "Submit' is clicked - please wait for thank-you message or notification of error - if there is an error it will be indicated by the field in question - fix and resubmit - once form has been processed you will receive two emails, 1) a copy of your registration and 2) a receipt for payment.