Rally Request Form

Rally Request Form
This form is due at least 30 days prior to an outdoor rally and 60 days prior to an indoor rally. Payment in full must be received 30 days prior to the rally date. Submission of a rally request form to the International Soap Box Derby does not automatically guarantee approval of race.
Today's Date*

MonthDayYear
Local Race Organization *Please do not abbreviate*
City *
State/Prov/Country*
Zip/ Postal Code*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What is your Region:*
Rally Race Date (Day 1)*

MonthDayYear
Rally Race Date (Day 2)

MonthDayYear
Rain Date (Day 1)

MonthDayYear
Rain Date (Day 2)

MonthDayYear
Rally Type*

OutdoorIndoor
Race to be run on*

Permanent TrackCity StreetOther
Do you use ramps?*

YesNo
If you use ramps how tall and long are they?*
Track Length*
Run Out Length*
Types of Barriers Used*
A rally race has a maximum registration fee of $35 per rally race.
Entry Fee*

NoOther
Wheel Swap*

2-4-24-0-4ProgessiveWheel BankOther
Do you anticipate having more than 500 people at your race? (including racers, volunteers, spectators, etc.)*

YesNo
Limitation on Number of Participants - C-3.02 Field size shall not limit less than 48 total participants, or less than 16 entrants per division for three divisions. The Race City must declare this limitation in writing on the website and post the field is full on website.
Stock Limitation
Super Stock Limitation
Masters Limitation
Type of Rally Weekend*

1 Day, 1 Rally ($625)1 Day, 2 Rallies ($700)2 Days, 1 Rally on the First Day and 1 Rally on the 2nd Day ($800)2 Days, 2 Rallies on 1st Day and 1 Rally on 2nd Day ($1,100)2 Days, 2 Rallies on 1st Day and 2 Rallies on 2nd Day ($1,300)
If you hold a single elimination Rally, you must hold a double elimination Rally first.
Day 1 Elimination (select all that apply)*

Double EliminationSingle EliminationTimer SwapOther
Day 2 Elimination (select all that apply)

Double EliminationSingle EliminationTimer SwapOther
Address/Location of Race Track*
Have you held a race at this location before?*

YesNo
Rally Director*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Cell Phone Number*

Area CodePhone Number
I certify that all foregoing facts are true to the best of my knowledge and I will accept all conditions herein.
Rally Director's Signiture*

Clear
Should be Empty: