Please be sure to print out this form and the W9 Form
Mail them to us along with your payment

Please print or type application

Name:______________________________________________ Birth Date__________________
Address:______________________________________________________ Car #____________
City:____________________________________ State:___________ Zip:__________________
Phone:____________________________________ SS#:_______________________________
Email:________________________________________________________________________
Car Owner's Name______________________________________________________________
Email:________________________________________________________________________

2007 season purse checks will be mailed to you!
No cash awards at the track!

Purse check payable to:_________________________Tax# or SS#______________________

SIGN MEMBERSHIP & W9 FORMS AND MAIL WITH PAYMENT TO:

INCAR
PO Box 7
Fortville, IN 46040

Legal Signature in ink:______________________________Date_______

Signature indicates you have read, understand and will abide by the release and waiver of liability and indemnity agreement below!

RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT

This section Must be Carefully Read and then Signed by that applicant on the first page of this form. In consideration of being permitted to enter for any purpose any Restricted Area (herein defined as including buy not limited to the racing surface, pit area, paddock area grandstand area, and all walkways, concessions and other areas appurtenant to any area where activity related to the event shall take place), or being permitted to compete, officiate, observe, work for, or for any purpose participate in any way in the event, EACH OF THE APPLICANTS, for himself/herself, his/her personal representatives, heirs, and next of kin, acknowledges, agrees and represents that s(he), or will immediately upon entering any of such restricted areas, and will continuously thereafter, inspect such restricted areas and all portions thereof which s(he) enters and with which s(he) enters and which s(he) comes in contact, and s(he) does further warrant that their entry upon such restricted area or areas and their participation, ifr any in the event constitutes an acknowledgment thats(he) has inspected such restricted are and finds and accepts the same as being safe and reasonably suited for the purpose of their use, and s(he) further agrees and warrants that if at any time, s(he) is in or about restricted areas and feels anything unsafe, s(he) will immediately advise the officials of such and leave the restricted area:

1: Hereby Releases, Waives, Discharges and Covenants Not To Sue the promoter, participants, racing association, sanctioning organization or any subdivision thereof, track operator, track owner, officials, car owners, drivers, pit crews and persons in any restricted area, promoters, sponsors, advertisers, owners and lessees of premises used to conduct the event and each of them, their officers and employees, all for the purpose herein referred to as "releases" from all liability to the undersigned, his/her personal representatives, assigns, heirs, and next of kin for any and all lose of damage, and any claim or demands thereof on account of injury to the person or property or resulting in death o fthe undersigned is in or upon the restricted are, and or, competing, officiating in, observing, working for, or for any purpose participating in the event:

2: Herby Agrees To Indemnify and Save and Hold Harmless the releasees and each of them form any loss, liability, damage, or cost they may incur due to the presence of the applicant in or upon the restricted area or in any way competing, officiating, observing, or working for, or for any purpose participating in the event and whether caused by the negligence of the releases or otherwise.

3: Hereby Assumes Full Responsibility For and Risk of Bodily Injury, Death due or Property Damage to the negligence of releases or otherwise while in or upon the restricted area and while competing, officiating, observing, or working for or for any purpose participating inn the event.
EACH OF THE APPLICANTS FOR MEMBERSHIP expressly acknowledges and agrees that the activities of the event are vary dangerous and involve the risk of serious injury and/or death and/or property damage. EACH OF THE APPLICANTS further expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by law of the Province or State in which the event is conducted and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. Each of the Applicants further agree that s(he) understands, accepts and shall adhere to all of the rules and regulations of International Championship Auto Racing The Sanction Body and understand that all decisions of the Sanctioning Body are official, final and binding without exception.

THE SIGNATURE OF THE APPLICANT ON THE ABOVE PAGE OF THIS LICENSE APPLICATION INDICATES S(HE) HAS READ, UNDERSTANDS, AND HAS VOLUNTARILY SIGNED THIS RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations, statements or inducements apart from the foregoing written agreement have been made.