MINERAL WELLS ATV CLUB, LLC

REGISTRATION FORM

MARK CLASS

__________                   CLASS 1          0-90CC YOUTH  12 AND UNDER, (OEM FRAME, PIPE, ENGINE, NO FACTORY PRODUCED RACE BIKE)

__________                   CLASS 2          YOUTH OUTLAW 1-125CC  12 AND UNDER

__________                   CLASS 3             POWDER PUFF

__________                   SENIOR           SENIOR 45 AND UP

__________                   CLASS 5          0-360CC 4-STROKE (STOCK UNCUT TRANSMISSION)

__________                   CLASS 6          0-330CC 2-STROKE

__________                   CLASS 7          0-500CC 4-STROKE

__________                   CLASS 8          0-400CC 2-STROKE

__________                   CLASS 9          0-1000CC 4-STROKE (SINGLE OR TWIN CYLINDER)

__________                   CLASS 10        0-450CC 4-STROKE (NO DIRTBIKES, OEM CLUCH COVER, NO DRAG AXLES, NO LOCK OUT CLUTCH, STOCK UNCUT TRANSMISSION, STOCK FRAME, NO OUTBOARD DRAG PIPES)

__________                   CLASS 11        0-700cc 4-STROKE or 500cc 2-stroke LIMITED (NO DIRTBIKES, OEM CLUCH COVER, NO DRAG AXLES, NO LOCK OUT CLUTCH, STOCK UNCUT TRANSMISSION, STOCK FRAME, NO OUTBOARD DRAG PIPES, KNOBBY TIRES, NO CLUB MEMBERS OR CLUB MEMBER BIEKS)

__________                   CLASS 12        0-416CC 4-STROKE (STOCK UNCUT TRANSMISSION)

__________                   CLASS 13        0-500CC 2-STROKE OR 0-800CC 4-STROKE

__________                   CLASS 14        OPEN UTILITY / SPORT UTILITY / UTV

__________                   CLASS 15        0-1500CC OPEN

DIRT BIKE CLASSES:

__________                   CLASS 16        0-100CC YOUTH  12 AND UNDER

__________                   CLASS 17         0-525CC MOTORCYCLE

ALL DIRT BIKES MAY JOIN THEIR APPROPRIATE ATV CALSS EXCEPT IN THE 450CC 4-STROKE AND THE 700CC 4-STROKE/500CC 2-STROKE LIMITED. NO DIRTBIKES WILL BE ALLOWED IN THESE CLASSES.

__________                   CLASS 19        POWER-WHEELS: OPEN, 5 AND UNDER – $5

*MAKE AND MODEL OF ATV, BIKE or UTV:_____________________________________                

 

LIABILITY WAIVER & RELEASE

Upon signing this Waiver & Release, I do understand that Mineral Wells ATV Club, LLC Members as a group or individually, will not under any conditions be held liable for any injuries or any kinds or nature which may occur or be received as a result of said participant’s participation I n said event, and hereby expressly waive all claims for injuries that may occur to myself or anyone I may injure, caused by myself or anyone else while being a participant, contestant, or spectator of said dirt drag event.

I acknowledge that I have read this Waiver & Release and do agree to it.

I have reviewed and will strictly observe the ATV Drag Rules and Regulations.

*PLEASE PRINT CLEARLY*

NAME OF PARTICIPANT                                                                                                  DATE____/_____/_____                                              

SIGNATURE                                                                                                                         PHONE NO.(   ) ______-_______                                     

**If Under 18 Years of Age; Parent Signature Required*

PRINT NAME OF PARENT/LEGAL GUARDIAN___________________________________________________                                                                                                  

SIGNATURE OF PARENT/LEGAL GUARDIAN____________________________________________________                                                                                                        

ADDRESS                                                                           CITY                                     STATE               ZIP_______