Kickin Roost

Kickin Roost Membership Application

To apply for membership please complete all questions.
Member Information
Name*

First NameLast Name
Is the member a minor?

YesNo
Name of parent if member is a minor
Additional Members (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 Member
Membership Fee Schedule
Additional Membership Fee Information

- Guest with members pay $20 at the gate

- Non-Member on open practice day pay $30 at the gate

-Membership does not include any racing fees

-Payments accepted check, cash, or Venmo (@kickinroost)
General Information
- Waiver forms will need to be signed for any member/non-member

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

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

-The membership will get you into the track 1 month before we open to the public in May

-All track rules and guidelines are required for all members/non-members

-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 or Erik erau@kickinroost.com

- We look forward to you being a member at Kickin Roost for the Inaugural Season.
I agree to the membership form guidelines contained in this document.
Signature*

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Date of Signature*

MonthDayYear
Date
My Products
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2024 Season Membership
$500.00

Additional Family Members
$50.00 Quantity

Total

$0.00
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Kickin Roost Membership Application

Member Information

Emergency Contact Information

Membership Fee Schedule

General Information