Class #______________________________

Sled #__________________________

XTREME RIDERS
2004 NORTH EAST OHIO SERIES OF GRASS

Registration Form

Registration: 8:00 AM to 10:00 AM, Go to tech area with sled first.
All performance protests need to be resolved prior to second round.
Any race disputes need to be addressed before start of next class.
RACE DIRECTOR'S DECISION IS FINAL

Fill out one form per class

Name:____________________________________________________________________

Address:____________________________________________________________________

City:______________________________________ State:______ Zip:__________________

Age:_____ (15 years old and under 500cc and under/under age 18 guardian signature required)

Phone:_________________________________________

Year:______________ Make:_____________________________ Model:____________________________

Motor size: ___________

Driver Liability: The driver/pit crew, in signing the entry, elects to use the course of the event at driver's/pit crews own risk, and thereby releases the sanctioning organization together with their heirs, assigns, officers, representatives, agents, employees, and members, sponsoring organization and owners of properties on which sanctioned events are to be held from all liability from injury to person, property and/or reputation that may be received by said entrant and from all claims of said injuries to the parties listed above growing out of, or caused by any construction or condition of the course over which the event is held. All Drivers are responsible for own insurance.

Participant/Guardian signature:______________________________________________ Date:_________

CLASS NAME: ______________________________ CLASS#: ______________________________

ENTRY FEES:
(Please circle the one that applies for this sheet)

Mini Sleds / Junior Novice………$10 ------------ Stock / Super Stock / Vintage…………$15

Open…………………………….$20 ------------ Top Gun………………………………$50

All Payout classes will have a $5 administration fee for each class, all trophy classes will have a $5 administration fee for each driver.