S A F E Motorsports

SEBRING INTERNATIONAL RACEWAY

Saturday, July 31, 2010 65 Cars Maximum

REGISTRATION FORM Club Membership Required

Member Name___________________________________________________________________

Mailing Address_________________________________________________________________

City___________________________________State____________Zip______________

Telephone: Day_____________________________ Eve_________________________________

REQUIRED Driver Medical Info: List drug allergies, current prescription medicines or health conditions that require special attention _______________________________________________

In the case of a track incident or emergency, name of relative or person to notify____________________

If not at track, their phone number: _______________________________________________________

Car Make/Model________________________________Year_______Color_____________________

Is this car primarily a: Street Car?_________or Competition Car?___________

Car Number: Your assigned Car Number must appear on both sides of your car.

What Car Number do you Arequest@? First choice____ Second choice_____ Third choice_________

Car Number requests are assigned in the order registration forms are received. Please list 2nd & 3rd choice.

ENTRY FEE: $350

.00

.00 Members Only

Additional Driver(s) sharing the same car registered above. EACH driver must be a Member of SAFE.

EACH driver must complete and send in a Registration Form. Additional drivers who are running with the club for the first time must register no later than 7 days prior to the event.

Entry fees: 1^st Driver of the car registered above pays full entry fee $350.

Additional Driver(s) sharing the same car pay $275 each (Club Membership is required).

Contact Phil Steinberg for Membership Applications and/ or additional Registration Forms.

Requirements for participation: All drivers must be current members of SAFE, who have received training in high speed performance driving and have previous experience driving a car at high speed on a road course circuit with other car, or driver must be sponsored by a Safe member.

Track time runs from 9 AM to 4 PM with an hour lunch break. All cars and drivers must be checked-in at Tech before the Drivers Meeting scheduled for 8:45 AM. Late arrivals for Tech check-in must have a valid reason for being late and will be charged a $25 late penalty fee before being allowed on course.

Refund Policy: You may cancel up to 1 week prior to the event, July 24^rd and receive a full refund.

Entry fees are non-refundable and non-transferable after this date. No Acredits@. We run rain or shine.

MAKE YOUR CHECK PAYABLE TO: SAFE MOTORSPORTS

Mail to: Phil Steinberg, Registrar

837 SW 56^th Street

Cape Coral, FL 33914

(239) 542-0806 (evenings) (239) 542-1888 (days) philipsteinberg@comcast.net