AXM Hilldrag Entry Form


Fill this form out and hit the SUBMIT button at the bottom.  You will need to fill out a form for each race.  You will also need to PRE REGISTER prior to the Race/Event your are registering for. Internet Registration closes at 10 pm Thursday prior to the race. Please read the Release at the bottom of this page prior to submitting this form

Unless other arrangements are made between AXM and you/your team you must be paid in FULL, before you the racer can enter the track for practice or racing. If you fail to be paid in full / register prior to the race you will be charged a $25 late charge at the upcoming event. This is all done to try and encourage racers to pre register so we can start on time on race day, and get a program together to hand out at the door to the fans.

Thank you & See you at the races, Nick

Please provide the following information:

                 Event MAKE SURE YOU PICK WHAT EVENT THIS ENTRY IS FOR!!!!!!

THIS WILL BE A ONE DAY EVENT ONLY (SATURDAY)

Name
Bib Number
Machine Brand
Street address
City
State/Province
Zip/Postal code
Home Phone
FAX
Soc. Sec. Number *Required for all PAYBACK classes
E-mail

 Please select from the following Classes:

 
SPECIALITY CLASS 100% Payback & Open to Pro and Semi Pro Drivers
 
Hotshot 100 (Open to Pro & Semi Pro drivers only)800 Improved Stock (up to 800cc liquid cooled improved stock machine) 100% Payback each weekend. Driver must enter one other Pro or Semi Pro class to race in the Hotshot Class $50.00
 
PRO CLASSES 75% Payback & Trophy for 1st Place
 
Pro 500 Improved Stock (up to 500cc Improved Stock Machines) $60.00
Pro 600 STOCK (up to 600cc Liquid Cooled STOCKmachines) $60.00
Pro 600 Improved Stock (up to 600cc Liquid Cooled improved stock machines) $60.00
Pro 700 Improved Stock (up to 700cc Liquid Cooled improved stock machines) $60.00
Pro 800 Improved Stock (up to 800cc Liquid Cooled improved stock machines) $60.00
Pro 900 Improved Stock (up to 900cc Liquid Cooled improved stock machines) $60.00
Pro 1000 (open chassis and engine up to 1000cc) $60.00
Pro Open (open chassis and engine) $60.00
 
SEMI PRO CLASSES 50% Payback & Trophies for 1st, 2nd, & 3rd
 
Semi Pro 500 Improved Stock (up to 500cc liquid cooled improved stock machines) $40.00
Semi Pro 600 STOCK (up to 600cc Liquid Cooled STOCKmachines) $40.00
Semi Pro 600 Improved Stock (up to 600cc liquid cooled improved stock machine) $40.00
Semi Pro 700 Improved Stock (up to 700cc liquid cooled improved stock machine) $40.00
Semi Pro 800 Improved Stock (up to 800cc liquid cooled improved stock machine) $40.00
Semi Pro 900 Improved Stock (up to 900cc liquid cooled improved stock machine) $40.00
Semi Pro 1000 (open chassis and engine up to 1000cc) $40.00
Semi Pro Open (open chassis and engine) $40.00
 

AMATEUR CLASSES Trophies for 1st, 2nd, & 3rd (Amateur classes are based more towards the Trail Rider and Machine)

 
Amateur 500 STOCK (up to 500cc liquid cooled STOCK machines) $20.00
Amateur 600 STOCK (up to 600cc liquid cooled STOCK machine) $20.00
Amateur 700 STOCK (up to 700cc liquid cooled STOCK machine) $20.00
Amateur 800 STOCK (up to 800cc liquid cooled STOCK machine) $20.00
Amateur 900 STOCK (up to 900cc liquid cooled STOCK machine) $20.00
Amateur Open (open chassis and engine up to 1000cc) $20.00
 
JUNIOR CLASS, WOMENS, & VINTAGE Trophies for 1st, 2nd, & 3rd
 
Junior 14 - 17 600 STOCK (up to 600cc liquid cooled STOCK machine) $20.00
Womens 600 STOCK (up to 600cc liquid cooled STOCK machine) $20.00
Vintage $20.00
     
ONE DAY Driver Insurance (each weekend per driver) IF YOU DO NOT CHECK THIS BOX YOU WILL STILL BE CHARGED IT ON YOUR CREDIT CARD IF YOU HAVE ONE ON FILE OR YOU WILL HAVE TO PAY BEFORE YOU RACE NO EXCEPTIONS $10.00
WEEKEND Insurance (each weekend per driver)If your going to race both days Check this box.IF YOU DO NOT CHECK THIS BOX YOU WILL STILL BE CHARGED IT ON YOUR CREDIT CARD IF YOU HAVE ONE ON FILE OR YOU WILL HAVE TO PAY BEFORE YOU RACE NO EXCEPTIONS $20.00
Registration by Credit Card IF YOU DO NOT CHECK THIS BOX YOU WILL STILL BE CHARGED IT ON YOUR CREDIT CARD $5.00

Membership (Check one Box)

 
Membership Area
$100 Already Paid Membership for season
$35 One Event Membership Only allowed 2 weekends
FREE

For the Amateur Class & Jr's Only IF YOU HAVE NOT RACED IN THE LAST 3 YEARS CHEK HERE. (Only allowed 2 weekend) Still Must do $10 Insurance

Annual Membership Already Paid

If you have already raced with us this year please list only NEW Sponsors or sponsors that you would like added.

 

BY SUBMITTING THIS FORM, THE ENTRANT INDICATES THEY HAVE READ AND AGREE TO THE RELEASE AND WAIVER

OF LIABILITY AND INDEMNITY AGREEMENT BELOW.

                            

 

 


Release and Waiver of Liability and Indemnity Agreement

In Consideration of being permitted to enter for any purpose any restricted area (herein defined as including but not limited to the racing surface, pit areas, infield, burn out area, approach area, shut down area and all walkways, concession and other areas appurtenant to any area where any activity related to the event shall take place), or being permitted to compete, officiate, observe, work for, or any purpose participate in any way in the event, each of the undersigned, for himself/herself, his/her personel representatives, heirs and nest of kin, acknowledges, agrees and represents that he/she has, or will immediately upon entering any of such restricted areas and will continuously thereafter, inspect such restricted area and that he/she finds and accepts the same as being safe and reasonably suited for the purpose of his/her use, and further agrees and warrants that if, at any time, he/she is in or about restricted areas and he feels anything to be unsafe, he/she will immediately advise the officials of such and will leave restricted areas:

1. Hereby releases, waives, discharges and Covenants not to sue the promoter, participants, racing association, sanctioning organization or any subdivision thereof, track operator, track owner, officials, owners, drivers, pit crews, any persons in restricted area, promoters, sponsors, advertisers, owners and lessees of premises used to conduct the event and each of them, their officers and employees, all for the purposes herein referred to as "Releasees", from all liability to the undersigned, his personal representatives, assignees, heirs, and next of kin for any and all loss or damage, and any claim or demands therefore on account of injury to the person or property or resulting in the death of the undersigned, whether caused by the negligence of the Releasees or otherwise while the undersigned is in or upon the restricted area, and/or competing, officiating in, observing, working for, or for any purpose participating in the event.

2. Hereby agrees to Indemnify and Save and Hold Harmless the Releasees and each of them from any loss, liability, damages, or cost they may incur due to the presence of the undersigned in or upon the restricted area or in anyway competing, officiating, observing, or working for, or any purpose participating in the event and whether caused by the negligence of the Releasees or otherwise.

3. Hereby Assumes Full Responsibility for and Risk of Bodily Injury, Death or Property Damage due to the negligence of Releasees or otherwise while in or upon the restricted area and/or while competing, officiating, observing, or working for or for any purpose participating in the event.

Each of the Undersigned expressly acknowledges and agrees that the activities of the event are very dangerous and involve the risk of serious injury and/or death and/or property damage. each of the undersigned further expressly agrees that the foregoing Release, Waiver and Indemnity Agreement is intended to be as broad and inclusive as permitted by the Law of the Province or State in which the event is conducted and that if any portion thereof is held invalid, it is agreed that the balances shall, not withstanding, continue in full legal force and effect.

THE ABOVE ENTRANT HAS READ AND VOLUNTARILY AGREES TO THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, AND FURTHER AGREES THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENTS APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE.

THE ABOVE ENTRANT ALSO UNDERSTANDS THE NO REFUND OF ENTRY FEE POLICY.

Last revised: October 1, 2009