2022 Autocross Registration Form

Specific Covid 19 Rules for all our 2022 events

Pre-Registration and Pre-pay requested, on-site registration MAY be available but NOT guaranteed.
Bring your own helmet (Snell 2010+) - some loaners may be available but BY RESERVATION ONLY.
The request info is on the entry form.

Please do not attend if you have any symptoms of illness.

You are required to bring a face mask.
Specific rules for mask wearing and distancing as well as other Covid rules will be published on the event flyer for each weekend event.

Please acknowledge you read the above statements *

Yes, I understand the specific rules for the Covid 19 events

Class:

Car #:

2nd #:

T-Shirt: *

Please double verify your Class and Car # are correct.

Full Name *

First Name Last Name

Age: *

Driver License # *

Address *

Street Address

Street Address Line 2

City State

Zip Code

Phone Number *

Email Address: *

Year:

Model:

Color:

Membership Options: (Membership runs from January 1 to December 31 for the current year ONLY.) *

Family ($30) Single ($20) Already Member None

Membership Fee:

Member Only Practice Day: (Member: $20) *

Yes No

Practice Fee:

IceBreaker: *

Yes No

IB Fee:

Select each Points Event you would like to prepay for (This does not include IceBreaker - select IceBreaker above):

Member: 1 to 3 prepaid events ($25/Event), 4th to the 6th prepaid events ($20/Event), 7th to the 8th prepaid event ($15/Event).

Non-Member: $30/Event: 1 to 8 Events

**** Note: NO Refunds are given for prepaid events. ****

Which events do you plan to attend? (You can attend any event but your best guess will help Registration.)

Event 1 ... Event 2 ... Event 3 ... Event 4 ... Event 5 ... Event 6 ... Event 7 ... Event 8

# of Events: (Please select your events above.)

***** Please note that if you don't have your Class and your Number on BOTH sides of your car then you will not pass Tech. If you have existing Letters and Numbers they MUST qualify for SCCA. This includes Size, Font, Color (must be contrast to your car color).

***** NO tape (masking, painter's, etc.) NO shoe polish.

Got Numbers? No, here is the solution, EESCC will be selling Magnetic Letters ($2/each) and Numbers ($3/each) for purchase and they will be available at Registration. They are a gloss black vinyl on a white background. Please enter your choices for your class and numbers in the boxes above (1st line on the form). If you don't know what they might be, you can still order the quantity below and Registration will help you decide what Class your call is in and what numbers are available.

***** Note: If your know you are going to run NFT you still NEED A CLASS on both sides of your car. We would also appreciate it if you put a "N" on each side of your car too BUT it is not a requirement, it would just help out Timing A LOT.

**** Your selection for a Number within your Class is not guarenteed until you arrive at Registration or you can Email the Chief of Registration to confirm your request. Please Email: Registrar@eescc.org

Remember to order Letters and Numbers for BOTH sides of your car, the quantity will probably be in multiple of twos.

Quanity of Letters you will need:

Remember, both sides of the car

Quanity of Numbers you will need:

Remember, both sides of the car

Letters & Numbers Fee

**** Covid-19 Update - Please Read ****

We are restricted to 100* people within the event at ALL times. It is possible that we will be required to stop anyone entering the event if we would exceed the 100* person limit for the event. This includes all persons within the event, drivers and ALL non-drivers. For example, if we exceed the 100* person limit before the afternoon sessions starts then we may* need some of the morning group to exit before the afternoon group can come onsite.

We would perfer this to be a "Driver's Only" event but your "Significant Other" will be allowed.

* This number could change based on the Phase II allowed group size.

Please acknowledge you read the above statements *

Yes, I understand the restrictions

There will be NO loaner helmets - you must bring our own legal helmet (Snell 2010+) *

Yes, I will bring my own helmet I would like to reserve a "M" size helmet for the Event (Reservation "will be confirmed") I would like to reserve a "L" size helmet for the Event (Reservation "will be confirmed") I would like to reserve a "XL" size helmet for the Event (Reservation "will be confirmed")

How many non-drivers will you bring to the Covid-19 event? (Do not count anyone that is a registered driver.) *

Enter a number of 0 if everyone is a registered driver

We would appreciate it if you would limit your extra non-driver's guests to 1 person to allow more drivers to participate at the event.

Thank You

Non-Driver's Name *

First Name Last Name

2nd Non-Driver's Name *

First Name Last Name

3rd Non-Driver's Name *

First Name Last Name

Are you and your party going to camp at the event? (Staying overnight) *

Yes No

Event Fee:

EESCC has started an Emerald Empire Motor Sports Park (EEMSP) Foundation to collect money to locate and develop a permanent location for EESCC, other clubs and/or public motorized activities to run autocrosses and other motorized events. Go to the EEMSP.org website for more information. Since the EEMSP Foundation is a 501(c)(3) organization, your donation is tax deductible (consult with your tax adviser or the IRS for verification), please donate by selecting one of the pre-defined amounts or enter any amount in the "Other Amount" box.

**** THANK YOU for your donation ****

Please select the tax deductable $ amount you would like to donate to EEMSP Foundation.

$0 $10 $20 $50 $100

**** Since you have selected "Other Amount", please enter a value greater than $0.00. If you do not want to donate to EEMSP then select the $0 option. ****

Today's Date:

Month Day Year Hour Minutes AM/PM Option

Total Fee:

Note: You can pay online via PayPal or by using your CC or DC (without using PayPal) by clicking the Pay Online button below. We, EESCC, will not get a notice / Email that you processed your registration via PayPal UNTIL the payment has been processed. If you didn't complete the PayPal process completely and still want to register, please use the EESCC Autocross Season Registration Form link from the EESCC website.

Pay Online Amt:

USD EESCC Season Registration

**** ERROR, if you have selected IceBreaker (Event1) then you must also have at least 1 Prepaid event. ****

**** ERROR, if you have selected 8 Prepaid events then you must also select IceBreaker (Event 1). ****

**** ERROR, you have not selected any option to purchase or donate. ****

2022 Autocross Series Registration Form