EVENT REGISTRATION
Personal Info
First Name
Last Name
Email
Phone
Street Address
City
State
Country
Zip Code
Role
Owner
Manufacturer
Builder
Association or
Club Affiliation
Referred By
Company
Prior Experience
Driving on a
Roadracing Circuit
(if none, write "none")
Emergency Contact Full Name
Emergency Contact Phone Number
Vehicle Info
Type
Car
Motorcycle
Make & Model
DOT Approved?
Yes
No
How is your vehicle powered?
Estimated
Horsepower
Crank
Wheel
Weight
Seating Capacity
Please describe safety equipment
(seatbelts, roll structures, etc.)
And Finally...
Do you want to participate in the SportElectric Time Trial?
(fastest lap competition, not wheel-to-wheel racing)
Yes
No
Maybe
Any Comments?