Light UP the NIGHT Participant Registration Form 2025

Light UP the NIGHT Participant Registration Form 2025

Please complete this form to its entirety $20 Pre-Registration Fee (Early Registration deadline is 06/09/2025) $25 registration fee at the gate. Event Date: 06/28/2025. Location: Acton Rec Area
Required Items:

- Fire Extinguisher- Must be securely mounted

- Open Rigs must have Roll Bar

- Seatbelts for All in Rig

- Battery must be secured- NO Bungee chords

- Tow point front and rear

- NO Alcohol for DRIVERS

** A TECH INSPECTION WILL BE PERFORMED AT REGISTRATION PACKET PICKUP- IF the above items are deficient, you will be turned away**

We highly recommend that you have basic recovery gear!
Driver Name*

First NameLast Name
Over 18?
Passenger Name

First NameLast Name
Age
Passenger Name

First NameLast Name
Age
Passenger Name

First NameLast Name
Age
StockModifiedSxSBuggy
Please provide a brief description of your RIG:
GMRSCBNone
YesNo
Cell Phone #
Format: (000) 000-0000.
E-mail*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

By signing and submitting this registraiton form, you understand and agree to all policies.

Once you click "Register" you will be redirected to pay the registration fee. You may use your credit/debit card or PayPal account to pay the fee. After payment is accepted- you will be directed to sign a waiver, if the waiver is not signed you will not be able to participate in the event.
Emergency Contact (First, last name, #, relationship)
Driver Signature*

First NameLast Name
Today's Date*

MonthDayYear
Date

My Products

Registration Fee

$20.00

Total

$0.00

Credit Card

Apple Pay

Google Pay