AMX Racing

Youth Driver Release Form

Driving race cars, motorcycles and ATV's is a dangerous hobby. In the event of a roll-over, all drivers will submit to an on-track EMT examination before resuming to race.

Any driver Under the age of 18, ( must have a signed and notarized release from a legal parent and/or guardian. See: Driver Information under the General Rules for Racers, Auto Moto Xcross, 2004 Rules.

By signing this release form, you are acknowledging and accepting the risks associated with racing.

Name of Driver________________________________D.O.B.___/___/____ Male_____ or Female _____

Address _______________________________________City_______________ST.________Zip________

Signature Please~
Parent or Legal Guardian ________________________________________Date_____________________

Printed Name Please~
Parent or Legal Guardian _________________________________________________________________

NOTARY PUBLIC

Subscribed and sworn to before me this _______day of __________________,2004 Affix Seal Here

Notary Signature ___________________________________

Printed Name _____________________________________

Notary Public for the State of ________________________

Residing at _______________________________, Montana

My Commission expires _____________________________

"RULES and REGULATIONS"