Spooktacular Registration Form

Northern Virginia Corvette Club
Spooktacular Registration Form
Saturday, October 27, 2012 starting at 9 AM
Sunday, October 28, 2012 starting at 12 PM
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. 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.

Registration is on a first come, first served basis and limited to 50 drivers. No refunds after October 20th.

Low Speed Cone Course on Saturday and High Speed Autocross on the famed Old Dominion Speedway 3/8 mile oval on Sunday. Seven events each day, two runs per event. For both Saturday and Sunday, the first seven runs count toward the first round of AutoX 1-7; runs 8-14 count as the second round of AutoX 1-7.

Overnight trailer parking is available at Old Dominion Speedway. Overnight lodging is available at: Olde Towne Inn, 9403 Main Street, Manassas, VA 20110 oldetowneinn.com

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:

Self-Rated Experience Level:

Registering For:

Track Events Attended:
(Include total # attended & list where/when details)

How did you hear about this event?

GENERAL PARTICIPANT REQUIREMENTS:
Event fees: Sat & Sun 14 AutoXs - $135 per driver, Sat OR Sun 7 AutoXs - $75 per driver
Must be at least 18 years of age, possess a valid drivers license and maintain current automobile insurance
Event is open to all vehicles, however non-Corvettes are not eligible for NCCC points
Helmets SA 2000 or newer; motorcycle helmets are NOT allowed. Helmets can be rented at www.ogracing.com
Long pants, long sleeved shirt, and closed toe shoes

HIGH SPEED PARTICIPANT REQUIREMENTS (Sunday ONLY):
Participants must possess a NCCC high speed license
Non-NCCC drivers must provide satisfactory proof of high speed driving skills to event chair in order to participate in Sunday's events
Vehicles must be equipped with a mounted fire extinguisher (5 BC minimum required)
Convertibles must be equipped with a 4-point roll bar (required in ALL Group 3 vehicles); roll bar questions should be resolved well in advance of event
Fire suits required in Group 3 vehicles

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