Name:
Address:
City, State, Zip:
Age:
Birthdate:
Phone Number:
Sponsors:
Email Address:
First Class Selection
Second Class Selection
Brand one
Third Class Selection
Fourth Class Selection
Brand two
Brand three
Brand four
Riders Signature:
Parent/GuardianSignature:
Please come to signup to pay entry fees and sign form
Bike # two
Bike # one
Bike # three
Bike # four
NONE
PEEWEE BEGINNER
PEEWEE AIR COOLED
PEEWEE 4-6
PEEWEE 7-9
PEEWEE OPEN
65 BEGINNER
65 6-8
65 9-11
65 OPEN
85 BEGINNER
85 Jr. 7-11
85 Sr. 12-16
85 OPEN
SUPERMINI
150F OPEN
SCHOOLBOY
250/450 BEGINNERS
250 NOVICE B
250 NOVICE
250 INTERMEDIATE
250 PRO
450 NOVICE B
450 NOVICE
450 INTERMEDIATE
450 PRO
OVER 25
OVER 30 A/B (EXPERT/INT)
OVER 30 C/D (NOV/BEG)
OVER 40
OVER 50
GIRLS 65-105
WOMENS 125-450
125 2 STROKE
250 2 STROKE
OPEN AMATEUR
NONE
ACTION
CANNONDALE
COBRA
EXTREME
HONDA
HUSQVARNA
KAESA
KAWASAKI
KTM
LAEGER
LEM
POLINI
SUZUKI
YAMAHA
NONE
ACTION
CANNONDALE
COBRA
EXTREME
HONDA
HUSQVARNA
KAESA
KAWASAKI
KTM
LAEGER
LEM
POLINI
SUZUKI
YAMAHA
NONE
ACTION
CANNONDALE
COBRA
EXTREME
HONDA
HUSQVARNA
KAESA
KAWASAKI
KTM
LAEGER
LEM
POLINI
SUZUKI
YAMAHA
NONE
ACTION
CANNONDALE
COBRA
EXTREME
HONDA
HUSQVARNA
KAESA
KAWASAKI
KTM
LAEGER
LEM
POLINI
SUZUKI
YAMAHA
I UNDERSTAND THAT THE LANDOWNERS, PROMOTORS, AND TRACK OFFICIALS, AND THE AMXA ARE IN NO WAY RESPONSIBLE FOR INJURY TO PERSONS, DAMAGE AND/OR LOSS OF PERSONAL PROPERTY. I DO KNOW THAT MOTORCYCLE RACING IS DANGEROUS AND THAT I AM RESPONSIBLE FOR MY OWN INSURANCE, AND I FURTHER UNDERSTAND THAT THERE MAY NOT BE AN AMBULANCE ON SITE FOR RACING EVENTS AND/OR PRACTICE. IT IS UNDERSTOOD THAT I MAY BE DISQUALIFIED AND/OR PENALIZED NOT ONLY FOR MY ACTIONS BUT THAT OF MY PIT CREW AND/OR FAMILY, AND IN SUCH EVENT, NO FEES WILL BE REFUNDED. IN THE EVENT THAT THE RACES ARE STOPPED FOR ANY REASON AND THE FIRST MOTOS HAVE BEEN COMPLETED, THE RACES WILL BE COMSIDERED COMPLETE. I ALSO UNDERSTAND THAT I WAIVE MAY RIGHT TO SUE FOR ANY REASON WHATSOEVER THE EVENT PROMOTOR, TRACK OWNER, LAND- OWNER, OR ANY ONE ELSE AFFILIATED WITH THIS SERIES OR RACING EVENT.
NONE
PEEWEE BEGINNER
PEEWEE AIR COOLED
PEEWEE 4-6
PEEWEE 7-9
PEEWEE OPEN
65 BEGINNER
65 6-8
65 9-11
65 OPEN
85 BEGINNER
85 Jr. 7-11
85 Sr. 12-16
85 OPEN
SUPERMINI
150F OPEN
SCHOOLBOY
250/450 BEGINNERS
250 NOVICE B
250 NOVICE
250 INTERMEDIATE
250 PRO
450 NOVICE B
450 NOVICE
450 INTERMEDIATE
450 PRO
OVER 25
OVER 30 A/B (EXPERT/INT)
OVER 30 C/D (NOV/BEG)
OVER 40
OVER 50
GIRLS 65-105
WOMENS 125-450
125 2 STROKE
250 2 STROKE
OPEN AMATEUR
NONE
PEEWEE BEGINNER
PEEWEE AIR COOLED
PEEWEE 4-6
PEEWEE 7-9
PEEWEE OPEN
65 BEGINNER
65 6-8
65 9-11
65 OPEN
85 BEGINNER
85 Jr. 7-11
85 Sr. 12-16
85 OPEN
SUPERMINI
150F OPEN
SCHOOLBOY
250/450 BEGINNERS
250 NOVICE B
250 NOVICE
250 INTERMEDIATE
250 PRO
450 NOVICE B
450 NOVICE
450 INTERMEDIATE
450 PRO
OVER 25
OVER 30 A/B (EXPERT/INT)
OVER 30 C/D (NOV/BEG)
OVER 40
OVER 50
GIRLS 65-105
WOMENS 125-450
125 2 STROKE
250 2 STROKE
OPEN AMATEUR
NONE
PEEWEE BEGINNER
PEEWEE AIR COOLED
PEEWEE 4-6
PEEWEE 7-9
PEEWEE OPEN
65 BEGINNER
65 6-8
65 9-11
65 OPEN
85 BEGINNER
85 Jr. 7-11
85 Sr. 12-16
85 OPEN
SUPERMINI
150F OPEN
SCHOOLBOY
250/450 BEGINNERS
250 NOVICE B
250 NOVICE
250 INTERMEDIATE
250 PRO
450 NOVICE B
450 NOVICE
450 INTERMEDIATE
450 PRO
OVER 25
OVER 30 A/B (EXPERT/INT)
OVER 30 C/D (NOV/BEG)
OVER 40
OVER 50
GIRLS 65-105
WOMENS 125-450
125 2 STROKE
250 2 STROKE
OPEN AMATEUR