Car-B-Que Registration Form

Northern Virginia Corvette Club
Car-B-Que Registration Form
Saturday, July 7, 2012 * 10 AM - 5 PM
Gates open at 8 AM * Open to all vehicles!
Old Dominion Speedway – 10611 Dumfries Road, Manassas, VA 20112
RAIN OR SHINE

Instructions: Please review the participant requirements below and fill in the application form completely. Your email address is KEY and mandatory for future communications. Please be sure your email address is entered correctly or your application will not be transmitted. You may receive emails with pertinent data you need prior to the event. Once you have completed the form, select "Submit Form"; you will receive a copy of what was transmitted to the registrar and a summary page will appear in your browser. Please PRINT THIS PAGE for your records. Then, click on the PayPal button to transmit payment for the event. You will receive a receipt for your PayPal payment via email. These steps are necessary in order for you to be registered.

• Try your hand as a driver during the Autocross 101 and Drag 101 sessions - Unlimited Runs!

• During & between races: Show off your ride at our Low Stress, Maximum Fun Cruise-In Car Show or buy & sell your gently used parts at the Swap Meet

• Raffle tickets will be available all day long, giving you a chance to win NVCC items, 50/50, and tickets to see hometown NASCAR racing under the lights

First Name:
Last Name:
NCCC Number (if applicable):
NCCC Vehicle Class (if applicable):
Email Address:
Street Address:

City:		State:		Zip Code:
Home Phone:		Work Phone:		Mobile Phone:

Vehicle to Register:
(No trucks, vans, SUVs, or crossovers)

Manufacturer	Model	Year	Color

Vehicle Modifications:

How did you hear about this event?

GENERAL PARTICIPANT REQUIREMENTS:
Car-B-Que Event Fee: $25 per vehicle; includes unlimited runs in Autocross 101 & Drag 101, and participation in Car Show and Swap Meet
Must be at least 18 years of age, possess a valid drivers license and maintain current automobile insurance
ALL vehicles participating in Autocross 101 and Drag 101 are subject to safety inspection
Helmets rated SA-2005 or better required on the drag strip - loaner helmets will be available
Sorry: For safety reasons, no vans, trucks, or SUVs can participate in the 101 sessions
Liability waiver MUST be signed

If you have any questions about this event, please email autoxhpde@nvcorvetteclub.com
If you have difficulty completing the online registration, please email webmaster@nvcorvetteclub.com