Driver's Name: (Each driver needs a form filled out)

First NameLast Name

Has the driver participated in a TKQMA Arrive and Drive before?

Driver's Date of Birth

MonthDayYear

Parent / Legal Guardian's Name

First NameLast Name

Parent's Primary Contact phone number

Please enter a valid phone number.Format: (000) 000-0000.

Parent's Email Address

example@example.com

Home Address

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Please arrive 10-15 minutes before your scheduled time slot to allow time to be fitted with safety gear that is required when operating cars on the track. All safety gear will be provided to use by TKQMA Club.

Acknowledgement

Please Select a Time Slot -

All drivers MUST come prepared wearing shirt, pants, socks, & closed toe shoes. By checking box below, you agree to come prepared with all of the above mentioned, and agree to all TKQMA rules, terms, & conditions. Please acknowledge by checking the box below.*

How did you hear about this event?

Please select an estimated size car your child would most likely fit best in, select all that apply.

Please list any information in the box below that we should know about your child to help and support them at the event. (Things such as: how to calm their anxious feelings or visual aids that work best when explaining things to them.) Anything you think we should know. (May leave blank also)

Would you like additional information on how to get started racing with us for our 2027 Race Season?

Would you like to become a club member of our TKQMA Race Club?

Would you like to know how you can help our local track, club and young racers for the upcoming 2027 season? Select all you might be interested in,

I have read and agree to the above waivers.

$20.00 for 10-Laps

10-laps consecitively is one session. If your child would like to sign up for additional time slots, you will need to complete this form again with the added time slot. Thank you!

Payment Amount

USDDescription

Credit Card

Will pay cash at the event when signing in

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https://www.facebook.com/tkqma

Please read:

$20.00 for 10-Laps

Payment Amount

Credit Card