• Full Name: ________________________________________
• Date of Birth: ________________________________________
• Address: ________________________________________
• Phone Number: ________________________________________
• Email Address: ________________________________________
• Emergency Contact Name & Number: ________________________________________

VEHICLE DETAILS
• Vehicle Make & Model: ________________________________________
• Registration or Competition Number: ________________________________________
• Engine Type ________________________________________
• Fuel Type: ________________________________________
• Send a Photo of Your Car (optional): streetskidsmotorsports@gmail.com

Select your Driver Category:
·       ☐ Apprentice Assassins (14–16 yrs)
·       ☐ Piston Pounders (Street Class)
·       ☐ Whine Lords (Blown)
·       ☐ Six Appeal (6-Cyl)

• T-shirt Size
• Dietary requirement

ACKNOWLEDGEMENT & WAIVER
Please read carefully before submitting:
- I acknowledge that I am entering the Rubber Riot Burnout Competition at my own risk.
- I agree to comply with all AASA event rules and follow directions from event officials.
- I waive all liability against Streetskids Motorsports Inc., Trayning Shire Council, and affiliated volunteers for injury, damage, or loss arising from participation.
- I confirm my vehicle meets basic safety requirements (seat belts, fire extinguisher, secure battery, etc.)
Do you agree to these terms and conditions?  please pick below

PAYMENT & CONFIRMATION
Entry Fee – $80 per Driver
Would you like to receive updates via email/text about future events?  Yes ☐   No ☐
Signature / Digital Confirmation

Thank you for submitting your nomination!