Power Wheels Drag Race Registration

Power Wheels Drag Race Registration

Orchard Days Activity- Sponsored by the Payson Santaquin Area Chamber of Commerce
Thursday, August 5th, 2021

400 W 100 S, Santaquin, Ut 84655
Participants Name*

First NameLast Name
Age*
Car No*
Parents Name (required if the participant is under 18 yrs.)

First NameLast Name
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Age division*
Type of Vehicle*
Size of Battery*
Child Waiver

To be filled out and signed by a parent or Legal Guardian
State of County of .
I, , being the parent and/or legal guardian of , herby consent to permit. To enter and/or participate in the Orchard Days, Power Wheels Drag Race, being held August 4th, 2021 and that said minor is under the age of 18. I hereby expressly release both the producer and sponsor and all of their associates for any injuries of any kind or nature, which may occur or be received as a result of said minor's participation in the said drag race. I expressly waive all claims for injuries that may occur should said minor be injured while being a contestant in said contest.
Parents and/or Legal Guardian:

Clear
Date of Signature:
Adult Waiver

To be filled out by the participating adult 18 yrs and older
State of County of .
I, , being of sound mind and body , herby consent to permit. To enter in the Orchard Days, Power Wheels Drag Race, being held August 4th, 2021. I hereby expressly release both the producer and sponsor and all of their associates for any injuries of any kind or nature, which may occur or be received as a result of my participation in the said drag race. I expressly waive all claims for injuries that may occur should I be injured while being a contestant in said contest.
Participant Signature

Clear
Date of Signature:
This event is a Fundraiser for the Payson Santaquin Area Chamber of Commerce. There will be prizes and trophies but ultimately, this event is for fun. Be Safe and Have Fun!

RULES:
- 12 volt single battery for the childrens divisions up to age 17.
- Modified cars are for the teen and adult divisions only.
- Participants must wear pants (no shorts) & shoes (no opened toes).
- Particiapnts must wear a helmet. Minimum of a bicycle helmet.
- Screws may be added to the tires for traction.

My Products

Driver Registration Fee

$25.00 Quantity

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Power Wheels Drag Race Registration

Thursday, August 5th, 2021

Child Waiver

Adult Waiver