CGI MOTORSPORTS DRIVING SCHOOL (DOC)

					                       2006 PERFORMANCE DRIVING SCHOOLS
                                 GINGERMAN RACEWAY - SOUTH HAVEN, MICHIGAN

NAME: _____________________________________________________________________________________

ADDRESS: __________________________________________________________________________________

CITY: __________________________________ STATE: _______________ ZIP CODE: ___________________

HOME PHONE: ___________________________ WORK PHONE: _____________________________________

FAX: ___________________________________ EMAIL: _____________________________________________

DATE OF BIRTH: ________________ DOCTOR: _________________________ PHONE: __________________

TRACK CAR BRAND: ______________________ MODEL: _____________________YEAR: ________________

EXPERIENCE (DRIVING SCHOOLS/LAPPING DAYS) _______________________________________________

___________________________________________________________________________________________

DRIVER'S LICENSE #_____________________________ AUTO INSURANCE CO________________________

      ENTRY FEE: $175.00*….MUST BE RECEIVED NO LATER THEN 2 WEEKS PROIR TO THE EVENT

                                       MARK OFF DATE(S) REQUESTED

               ____MAY 8, 2006     ____MAY 22, 2006    ____JUNE 5, 2006   ____JUNE 19, 2006

         ____JULY 3, 2006        ____JULY 17, 2006    ____JULY 31, 2006   ____AUGUST 14, 2006

 ____AUGUST 28, 2006       ____SEPTEMBER 11, 2006 ____SEPTEMBER 25, 2006 ____OCTOBER 9, 2006


*PLEASE NOTE: A CHECK OR MONEY ORDER MUST ACCOMPANY THE APPLICATION. ONCE CONFIRMED CANCELLATION
 REFUNDS WILL BE GIVEN ONLY IF THE ENTRY IS FILLED. MAKE CHECKS PAYABLE AND MAIL WITH APPLICATION TO:

                                  CGI MOTORSPORTS
                                  13525 CHIPPEWA TRAIL
                                  LOCKPORT, IL 60441
Would you prefer your confirmation be sent: []E-mail []Fax []Snail-mail (Please check one)

I HEREBY APPLY AS A DRIVER FOR “CGI MOTORSPORTS DRIVING SCHOOL” CONDUCTED AT GINGERMAN RACEWAY. I
UNDERSTAND THAT HIGH SPEED DRIVING EVENTS HAVE INHERENT RISKS THAT CANNOT BE FORESEEN OR ELIMINATED
NO MATTER HOW EXPERIENCED THE DRIVER IS, OR HOW WELL THE CAR IS PREPARED FOR SUCH AN EVENT. ALTHOUGH
DRIVING AND SAFTEY GUIDELINES ARE REVIEWED WITH ALL PARTICIPANTS, THE EVENT ORGANIZERS HAVE NO DIRECT
CONTROL OVER AN INDIVIDUAL DRIVER’S BEHAVIOR ON THE TRACK.

ACCIDENTS OR COLLISIONS WITH OTHER VEHICLES MAY RESULT IN DEATH, PERMANENT INJURY OR DISABLITY. CAUSES
OF ACCIDENTS INCLUDE BUT ARE NOT LIMITED TO EQUIPMENT FAILURE, CHANGING TRACK CONDITIONS, DRIVER ERROR
OR DRIVER NEGLEGENCE. I AGREE TO FOLLOW ALL RULES ESTABLISHED FOR THE EVENT AND I AGREE TO FOREFIT ALL
ENTRY FEES IF I’M EJECTED FOR VIOLATION OF SAID RULES.

I HAVE PREPARED MY VEHICLE FOR THIS EVENT HOWEVER, I AM ALSO AWARE THAT EQUIPMENT FAILURE COULD RESULT
IN INJURY OR DEATH. I FREELY ACCEPT THE RISKS INHERENT IN A DRIVING SCHOOL. I AGREE THAT I AND MY HEIRS
RELEASE GINGERMAN RACEWAY, ITS OWNERS AND STAFF, EVENT ORGANIZERS, CGI MOTORSPORTS, ITS OFFICERS AND
THEIR ESTATE FROM ANY LIABILITY RESULTING FROM PARTICIPATING IN THIS EVENT.


STUDENT’S SIGNATURE (required) _______________________________________________ DATE_______________________

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□CGI Web Site □Gingerman Web Site □Audi Web Site □Flyer □Friend □Other_____________________
CGI 2006 App

				
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