West Michigan Offroad
2011 Entry Form
Entrant's Name:___________________________________________________________________________
Address:_____________________________________________________________________
City:_________________ State:___________ Zip:________
Phone:________________________ Car #:______________
The Undersigned hereby represents and certifies that:
1. I am at least 18 years of age(16 & 17 w/parent consent)
2. I have voluntarily entered a W.M.O.R. Racing Venue.
3. I understand the promoter does not cover medical & transport.
4. I have read the rules & understand the meaning of them.
I hereby release and agree to hold harmless and not sue, West Michigan Off Road LLC, the promoters, The Owners, Lease's of the premises, other participants, office directors, officials, representatives and all employees from all liability, loss, damage or injury (including death) to me in any way resulting from or arising in connection with the West Michigan Off Road Racing series at any venue, either in race competition or in preparation thereof or while participating in or assisting with the event, voluntarily and in reliance upon my own judgement and ability. therefore assume all risk, loss, damage, injury (including death) to myself and my possessions. Furthermore, by participating in this event, I understand that the decision of the judges is final and that abiding by the decisions of the judges and officials is a prerequisite for continuance of participation.
DriverSignature:___________________________ Date:_______________
May 7____ May 21____ June 4____ June 25____ July 2 (I-96) ____ July 29(Muskegon)____ Aug.6 (Ingham Co.)____ October 15, ( Fremont )_________
Entry fee of $40.00 must accompany entry form. ( Exception, Fremont - $30.00 )
Car #____________
Heat _____________
Position ___________