Car Information 

Make ________________________Model _______________________Year  ______  Color ____________    

Car Modifications ________________________________________________________________________

Roll Bar     Yes     No        Roll Bar is required in convertibles in all groups ABOVE the beginner group

Driving Skill. You will be grouped with people who have similar experience levels. Indicate the level that best describes your experience: ______  

1 (No Experience);

 2 (2 previous track days or more than 10 autocrosses); 

3 (6 or more track days); 

4(8 days & working on passing in corners);  

5 (comfortable with traffic and unrestricted passing in corners); 

6(race licensed)

List other driving experience:__________________________________________________________________ __________________________________________________________________________________________

__________________________________________________________________________________________

Have you attended our school more than twice before?   No    Yes ( _____ times)

I want to receive instruction for:  _____ A (basics for beginners, no roll bar required); B (advanced driving techniques); C (corner passing techniques); D (special instruction advanced & racing technique)

Please list your Medical Insurance provider:___________________________________

Payment

Total Cost

Student entry (includes student meals, Fri & Sat PM & Sat & Sun lunch & T-shirt)

$385.00 each

Tshirt size (circle one)   XXXL  XXL    XL    L    M   S

Free with entry

Guest dinner - Friday

$15 each

Guests dinner - Saturday

$15 each

Guest lunch - Saturday

$10 each

Guest lunch - Sunday

$10 each

Total