Kickin Roost

Kickin Roost Yearly Pass Holder Application

To apply for Yearly Pass please complete all questions.
Pass Holder Information
Name*

First NameLast Name
Is the pass holder a minor?

YesNo
Name of parent if pass holder is a minor
Additional Pass Holders (direct family)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
example@example.com
Phone Number
Please enter a valid phone number.
Emergency Contact Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship to Pass Holder
Yearly Pass Holder Fee Schedule
Additional Yearly Pass Holder Fee Information

- Pass holder does not include any racing fees

-Payments accepted check, cash, Square (Credit Card) or Venmo (@kickinroost)
General Information
- Waiver forms will need to be signed for any yearly pass holder or non-pass holder

- In the event of a minor, a parent/legal guardian will need to fill out a waiver for the minor and adult

-Pass holder gives you access to unlimited visits to track durning our posted open track days (see schedule for more details)

-All track rules and guidelines are required for all pass holders and non-pass holders

-Safety is our upmost goal at Kickin Roost next to having a blast!

-Any questions please feel free to reach out to David dkirkbride@kickinroost.com
I agree to the Pass Holder form guidelines contained in this document.
Signature*

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Date of Signature*

MonthDayYear
Date
My Products
prevnext( X )
Pass Holder 1 individual person
$500.00

Additional Pass Holder
$100.00 Quantity

Total

$0.00
Should be Empty:

Kickin Roost Yearly Pass Holder Application

Pass Holder Information

Emergency Contact Information

Yearly Pass Holder Fee Schedule

General Information