2009 Roadracing School Application
Sponsored by Dunlop tires
School Dates are tentative:	7/3/2009 7/24/2009 (New Jersy Motorsports Track) 8/28/2009
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