Maxxis Tires Contingency Redemption

Contingency Claim Form

Complete this form for each day that you won this contingency. All submissions will be verified with the official posted results. Any cheating will result in a permanent ban from this program.
Maxxis Tires contingency program details can be found HERE.

Active NASA Members receive a special discount on select MAXXIS tires.

NASA Members - 10% Off VR-1/RC-1/R19 Tires*
*205/50/15 size tires are excluded from this discount program

Register for your Maxxis Tires Discount HERE
Driver's Information
If claiming as a team. Please input the driver's full name in the "First Name" field and the team name in the "Last Name" field.

Example - First Name "Johny Racer" / Last Name "Team NASA Racing"
Driver Name*

First NameLast Name
Shipping Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
Email*

Confirmation Email
Event Details
NASA Region*
Track Name*
Race Date*

MonthDayYear
Note: Contingency form must be submitted within 30 days of the event conclusion
Car, Class, and Tire Information
Year*
Make*
Model*
Race Class*
Tire Model*
Maxxis Tire Size*
Make sure to select a correct tire size
Race Results and Compliance
Claiming for?*

Regional CompetitionNational ChampionshipEndurance Race
Total Number of Classified Starters*
Note: Must match the number on the official results
Does not Meet Program Requirements*
Finishing Position*
Official Results*

Browse Files
Must be downloaded from https://drivenasa.com/results/ Cancelof
Four (4) pictures of your car showing required decals. Front, back, and sides. Pictures must be taken at the track during the event with Geo Tagging enabled. Any modifications to the original pictures will result in denial of the claim and a permanent ban from the program.
Front*

Browse Files

Cancelof
Rear*

Browse Files

Cancelof
Passenger Side*

Browse Files

Cancelof
Driver Side*

Browse Files

Cancelof
Proof of Purchase Requirements
Invoice MUST show purchase date. The purchase date may not be older than 1 year.

Invoices that do not show a valid purchase date or older than 1 year will be rejected and contingency claims will be denied.
Proof of Tire Purchase*

Browse Files

Cancelof
Order Number*
Maxxis Tires and contingency prizes can only be purchased and redeemed at shop.maxxis.com They will not offset any applicable tax, shipping, or handling fees.

A summary of this redemption request will be emailed to you upon submission. Please allow 30 days to process your claim. For any questions regarding this program please join the conversation on our #DRIVENASA Community Forums.
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Contingency Claim Form

Driver's Information

Event Details

Car, Class, and Tire Information

Race Results and Compliance

Proof of Purchase Requirements