Driver of Record:
Name:_____________________________ DOB:__,__,____ Age:___ Phone:__________
Address:_________________________________________________Alleries________
Email:___________________________, Signature:____________________________
Co-Driver:
Name:_____________________________ DOB:__,__,____ Age:___ Phone:__________
Address:_________________________________________________Allergies___________
Email:___________________________, Signature:____________________________
Co-Driver:
Name:_____________________________ DOB:__,__,____ Age:___ Phone:__________
Address:__________________________________________________Allergies___________
Email:___________________________, Signature:____________________________
Name:_____________________________ DOB:__,__,____ Age:___ Phone:__________
Address:_________________________________________________Alleries________
Email:___________________________, Signature:____________________________
Co-Driver:
Name:_____________________________ DOB:__,__,____ Age:___ Phone:__________
Address:_________________________________________________Allergies___________
Email:___________________________, Signature:____________________________
Co-Driver:
Name:_____________________________ DOB:__,__,____ Age:___ Phone:__________
Address:__________________________________________________Allergies___________
Email:___________________________, Signature:____________________________
Class: ( check one) Sportsman___,
Razors___,UTV__,1__,Trophy__,3__,
5/1600__,5 open__,
7__,7s__,8__,8s__,9__,10__,12__,16__,
17__,1450__,other__
Razors___,UTV__,1__,Trophy__,3__,
5/1600__,5 open__,
7__,7s__,8__,8s__,9__,10__,12__,16__,
17__,1450__,other__
Race:_______________, Vehicle #______
REQUIRED TO RACE
Helmets ____ Snell, DOT
Seat Belts ____4,5point(*3point)
Race suits ____SFI labeled
Window nets ____
(Arm restraints)_____
Roll Cage ____full
(Factory Roll Cage)
First Aid Kit ____
Tow Strap _____
Fire Extinguisher _____2.5 lbs
(Trophy trucks Fire Suppressant)__
Amber light ____ 1 (yellow)
Brake lights ____ 1(Red)
Secure Battery _____ ( Dry Cell)
Fuel Cell ____ industry standard
GPS Navigator Model ________
Racer Initials____
Tec official_____
Helmets ____ Snell, DOT
Seat Belts ____4,5point(*3point)
Race suits ____SFI labeled
Window nets ____
(Arm restraints)_____
Roll Cage ____full
(Factory Roll Cage)
First Aid Kit ____
Tow Strap _____
Fire Extinguisher _____2.5 lbs
(Trophy trucks Fire Suppressant)__
Amber light ____ 1 (yellow)
Brake lights ____ 1(Red)
Secure Battery _____ ( Dry Cell)
Fuel Cell ____ industry standard
GPS Navigator Model ________
Racer Initials____
Tec official_____
Entry Fees:
Pro Entry Fee = 265.00 _____
Sportsman Fee: 155.00 _____
One race Member Fee: 20.00 _____
or
2010 EDR Membership: 30:00 _____
Optional (Hooters Sprint for Cash): 20.00 _____
Total payed: ______
Cash only at Tec-Reg
Make checks payable to Extreme Desert Racing
P.O. Box 91615 Austin, Tx 78709, due by March 20th
No Checks at Track, Cash only
Recieved By:__________
Entry Fee: 130.00
Insurance: 75.00
Pay back: 60.00
60-30-10 payback
Pro Entry Fee = 265.00 _____
Sportsman Fee: 155.00 _____
One race Member Fee: 20.00 _____
or
2010 EDR Membership: 30:00 _____
Optional (Hooters Sprint for Cash): 20.00 _____
Total payed: ______
Cash only at Tec-Reg
Make checks payable to Extreme Desert Racing
P.O. Box 91615 Austin, Tx 78709, due by March 20th
No Checks at Track, Cash only
Recieved By:__________
Entry Fee: 130.00
Insurance: 75.00
Pay back: 60.00
60-30-10 payback
Extreme Desert Racing LLC. John Clark,512-848-4344 fax 512-288-4061 / Email: John@Texasoff-road.com
Registration & Tec Form
I understand that EDR Reserves the right to Refuse any Vehicle or Persons from entering the
race for any reason. A full refund will be returned if vehicle or persons have not entered Event.
I also acknowledge to the best of my ability, that my vehicle is in good condition to race. I assume
all responsibility of my actions with my vehicle and hold Harmless any part of the EDR
organization.
_____________________________, __________, ____________________________
Driver Signature date Print Name
race for any reason. A full refund will be returned if vehicle or persons have not entered Event.
I also acknowledge to the best of my ability, that my vehicle is in good condition to race. I assume
all responsibility of my actions with my vehicle and hold Harmless any part of the EDR
organization.
_____________________________, __________, ____________________________
Driver Signature date Print Name
Extreme Desert Racing
West Texas, Hill Country, Pan Handle
West Texas, Hill Country, Pan Handle
EDR
EDR
Extreme Desert Racing LLC.