2008 Roadracing School Application
Sponsored by Dunlop tires
School Dates are tentative:
9/5/2008
7/4/2008
5/24/2008
First Name:
Last Name:
Street:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Neveda
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:
E-mail Address: (valid email)
Home Phone:
Work Phone:
Date of Birth:
Emergency Contact:
Number:
Have you ever been a MARRC member?
yes
no
Member #
What motorcycle(s) do you plan to use for the Roadracing school?
Make:
Model:
Year:
Condition:
Is your motorcycle ready for racing?
yes
no
What previous racing or track experience do you have?
I acknowledge that I am fully aware of the hazards and dangers involved in motorcycle road racing. I hereby assume all risks involved in my participation on this event. I hereby indemnify and agree to hold MARRC, its officers, agents, members, servants, volunteers, and/or employees harmless of and from any and all claims, demands, actions, causes of action or suits of any kind or nature, whatsoever, now, or at any time in the future related to participating in the MARRC RRS.
To receive the special pre-registration price of $250.00, you must register at least two weeks prior to the school. Registration received after two weeks prior to the class will be considered walk-in and charge the standard rate of $275.00. To pre-register, mail a check for payment in full with this form to the address below or use PayPal to send in your payment. You can register at the track only if there are openings available for that school. Call first to check. Walk-in registration at the track costs $275.00.
This tuition is a non-refundable deposit, unless all sessions of the school are filled. If you must re-schedule a class, it must be done at least two weeks prior to that class. The deposit is not transferable other than among the dates listed above for 2006. You must be at least 14 years old.
For your convenience you are now accepting PayPal as form of payment.
You may either mail-in your payment or use the PayPal button on the next page.
MAIL DEPOSIT TO:
MARRC-RRS
Attn: Dawn Greer
1264 Freezeland Road, Linden, Virginia 22642