2016 PAYOUT 051016

MUST BE PRINTED IN COLOR

2016 Wythe Raceway Minor Release Form VALID ONLY IF PRINTED IN COLOR 041216-1

MUST BE PRINTED IN COLOR

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INSTRUCTIONS TO FILL OUT PARENTAL CONSENT FORM FOR MINORS.

MUST BE PRINTED IN COLOR*

1: Both PARENTS HAVE TO SIGN A SEPARATE COPY OF PAGE 1

1a: If the witness is not  a Track Official, the witness must be 18 or older and signed in front of a notary and then get the form notarized.

This only has to be done once, Wythe Raceway will keep the form on file.

*Forms MUST BE printed in color.

Page 1 of 2

parent or guardian sign             print name of parent or guardian                  then date

signature of witness                  print name of witness          Name and age of minor participant

2: MINOR HAS TO READ AND SIGN BOTH COPIES OF PARENTAL FORM.

2a: If the witness is not  a Track Official, the witness must be 18 or older and signed in front of a notary and then get the form notarized.

Forms MUST BE printed in color.*

Page 2of 2             Minor’s Assumption of risk

Signature of Minor Participant                                         DATE

Printed Name of Minor Participant                                  AGE

Witness sign                                                                    Printed name of witness

IF NOT SIGNED AT WYTHE RACEWAY:  ALL SIGNATURES MUST BE NOTARIZED.

The Parental form must be filled out correctly and presented to the Minor window.

You do not have to make copies. Wythe Raceway will keep the forms on file.

Everyone going in the Restricted Pit Area must purchase an arm band.

Once this is done correctly you will not have to be with parents or bring any additional copies, you can simply purchase an armband and go to pits.