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Carroll County Farm Bureau Tractor Parade – Driver Application


									              Carroll County Farm Bureau Tractor Drive
                         Driver Application
                       Tuesday, August 5, 2008

Personal Information: (Please Print Clearly)
Name: __________________________________________________________________
Address: ______________________________________________________________
City: ____________________________ State: _________ Zip: _________________
Home Phone: _____________________ Cell Phone: ______________________
Clearly Print How Your Name Is To Appear On The Name Tag:______________________

Email Address: ________________________________________________________
Tractor Information:
Tractor Make: ___________________ Model: ________________ Year:______
Road Speed of Tractor: ____________ (min 10 mph)
I will be leaving my tractor at the fair overnight _________

                       Driver Safety Pledge
I, ________________________, Pledge that by signing the safety pledge for the
Carroll County Tractor Ride 2008 I agree to abide by all the rules set
forth and that my tractor and I will meet all necessary requirements.
      I have a valid driver’s license.
      I have insurance on my tractor which is considered a motor vehicle
        while driving on Illinois roads. (proof of insurance required)
      I will follow all traffic laws.
      I will not carry riders along on my tractor.
      I will stay with assigned group.
      I will not pull anything with my tractor during the ride.
      I will have an smv sign posted on my tractor
      I will follow the instructions of the group leader and sponsoring
      I will not pass other tractors on the ride unless instructed.
      I will not consume any alcohol while driving my tractor.
      I will maintain a safe yet close distance between tractors.

Signature: _________________________________________ Date: _______________

Please mail this form with a check in the amount of $35 payable to the
Carroll County Farm Bureau to:
811 South Clay Street
Mount Carroll, IL 61053

Registration is limited to the first 75 tractors. Questions? Contact the
Carroll County Farm Bureau at 815-244-3001.

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