Post by Admin - JoAnne Mady on Jan 13, 2014 12:09:06 GMT -5
2014 XCEL CHASSIS DRIVER/CAR OWNER REGISTRATION
DRIVER NAME:_______________________________________________________________ CAR #:__________
DRIVERS DIVISION:________________________________________
DRIVER HOMETOWN:______________________________________
PRIMARY SPONSOR:__________________________________________________
TRANSPONDER #:__________________________
CAR OWNER:_________________________________________ S.S # ___________________________________
OWNER ADDRESS:_____________________________________________
CITY__________________________________STATE_________ZIP CODE____________
PHONE NUMBERS CELL:___________________________ HOME:_______________________________
FOR MASS TEXTING LIST
PLEASE FILL OUT COMPLETELY
THE PERSON THAT ANY PURSE OR POINT FUND MONIES ARE PAID TO SHOULD BE LISTED
ABOVE AS CAR OWNER WITH COMPLETE INFORMATION PROVIDED. NO MONIES WILL BE PAID UNLESS COMPLETE INFORMATION IS COMPLETEDIN CONSIDERATION OF THE ACCEPTANCE OF THIS XCEL CHASSIS REGISTRATION/PARTICIPATION FORM FORM,I MYSELF, MY HEIRS, NEXT OF KIN, PERSONAL REPRESENTATIVES AND SSIGNS, FOREVER RELEASE,REMISE AND FOREVER DISCHARGE AND AGREE TO HOLD HARMLESS AND IDEMNIFY THE PROMOTERS PRESENTING THE RACES OR OTHER EVENTS, THE OWNERS OF THE PREMISES AT WHICH THESE EVENTS ARE HELD, THE PARTICIPANTS, THEREON, AND THE OWNERS, SPONSORS AND MANUFACTURESERS OF ALL RACING EQUIPMENT USED IN ANY OF THESE EVENTS, THE OFFICERS, DIRECTORS,AGENTS INCLUDING OFFICIALS AND XCEL CHASSIS LLC PARTICIPANTS, OF AND FROM LIABILITY,CLAIMS,ACTION AND OF POSSIBLE CAUSES OF ACTION WHATSOEVER. INCLUDING NEGLIGENCE OF ANY OF THE FORGOING, THAT MAY ACRUE TO ME OR MY HEIRS, NEXT OF KIN AND PERSONAL REPRESENTATIVES FROM EVERY AND ANY LOSS, DMAGE AND INJURY, INCLUDING DEATH, THAT MAY BE SUSTAINED BY MY PERSON AND PROPERTY WHILE IN OR ABOUT AND ENROUTE INTO AND OUT OF ANY XCEL CHASSIS EVENT.
BY SUBMITTING THIS REGISTRATIONFORM, I ACKNOWLEDGE THAT I HAVE READ THE ENTIRE FORM AND UNDERSTAND ITS CONTENTS. XCEL CHASSIS HAS CONSENT TO USE DRIVER NAME AND LIKENESS FOR PROMOTIONAL AND SOUVENIR MATERIALS. REGISTRATION MUST BE FILLED OUT COMPLETELY IN ORDER TO RECEIVE ANY AND ALL MONIES DUE. IF REGISTRATION IS ELECTRONICALLY SUBMITTED, THIS WILL BE CONSIDERED YOUR SIGNATURE FOR THE ABOVE FORM.
SIGNATURE _________________________________________________________________
. REGISTRATION FORMS CAN BE SENT TO joannemady@yahoo.com
THANK YOU
JOANNE MADY
DRIVER NAME:_______________________________________________________________ CAR #:__________
DRIVERS DIVISION:________________________________________
DRIVER HOMETOWN:______________________________________
PRIMARY SPONSOR:__________________________________________________
TRANSPONDER #:__________________________
CAR OWNER:_________________________________________ S.S # ___________________________________
OWNER ADDRESS:_____________________________________________
CITY__________________________________STATE_________ZIP CODE____________
PHONE NUMBERS CELL:___________________________ HOME:_______________________________
FOR MASS TEXTING LIST
PLEASE FILL OUT COMPLETELY
THE PERSON THAT ANY PURSE OR POINT FUND MONIES ARE PAID TO SHOULD BE LISTED
ABOVE AS CAR OWNER WITH COMPLETE INFORMATION PROVIDED. NO MONIES WILL BE PAID UNLESS COMPLETE INFORMATION IS COMPLETEDIN CONSIDERATION OF THE ACCEPTANCE OF THIS XCEL CHASSIS REGISTRATION/PARTICIPATION FORM FORM,I MYSELF, MY HEIRS, NEXT OF KIN, PERSONAL REPRESENTATIVES AND SSIGNS, FOREVER RELEASE,REMISE AND FOREVER DISCHARGE AND AGREE TO HOLD HARMLESS AND IDEMNIFY THE PROMOTERS PRESENTING THE RACES OR OTHER EVENTS, THE OWNERS OF THE PREMISES AT WHICH THESE EVENTS ARE HELD, THE PARTICIPANTS, THEREON, AND THE OWNERS, SPONSORS AND MANUFACTURESERS OF ALL RACING EQUIPMENT USED IN ANY OF THESE EVENTS, THE OFFICERS, DIRECTORS,AGENTS INCLUDING OFFICIALS AND XCEL CHASSIS LLC PARTICIPANTS, OF AND FROM LIABILITY,CLAIMS,ACTION AND OF POSSIBLE CAUSES OF ACTION WHATSOEVER. INCLUDING NEGLIGENCE OF ANY OF THE FORGOING, THAT MAY ACRUE TO ME OR MY HEIRS, NEXT OF KIN AND PERSONAL REPRESENTATIVES FROM EVERY AND ANY LOSS, DMAGE AND INJURY, INCLUDING DEATH, THAT MAY BE SUSTAINED BY MY PERSON AND PROPERTY WHILE IN OR ABOUT AND ENROUTE INTO AND OUT OF ANY XCEL CHASSIS EVENT.
BY SUBMITTING THIS REGISTRATIONFORM, I ACKNOWLEDGE THAT I HAVE READ THE ENTIRE FORM AND UNDERSTAND ITS CONTENTS. XCEL CHASSIS HAS CONSENT TO USE DRIVER NAME AND LIKENESS FOR PROMOTIONAL AND SOUVENIR MATERIALS. REGISTRATION MUST BE FILLED OUT COMPLETELY IN ORDER TO RECEIVE ANY AND ALL MONIES DUE. IF REGISTRATION IS ELECTRONICALLY SUBMITTED, THIS WILL BE CONSIDERED YOUR SIGNATURE FOR THE ABOVE FORM.
SIGNATURE _________________________________________________________________
. REGISTRATION FORMS CAN BE SENT TO joannemady@yahoo.com
THANK YOU
JOANNE MADY