Driver’s Name (Print): / Kart Club:
Street Address: / License Number:
City: / Province/State: / Postal Code/ZIP Code:
Phone: / Mobile: / Fax:
Date Of Birth: Month: Day: Year: / Email:

Championship Classes –Please indicate your class and your preferred Kart Numbers. (Three-digit numbers are allowed for all Rotax Classes).

√ / Kart No.
(1stpick) (2ndpick) / √ / Kart No.
(1stpick) (2ndpick)
Rotax Micro Max / Rotax Masters
Rotax Mini Max / Rotax DD2
Rotax Junior / Rotax DD2 Masters
Rotax Senior / Transponder Numbers(see Note 2)

Regional Classes – Please indicate your class and your preferred Kart Numbers.

/ No. 1
Honda Senior / Honda Masters / No. 2
Honda Junior

Note 1Kart numbers for Honda are assigned on a “first come, first served” basis.

Note 2Include your complete transponder number if you are using your own. For those registering 2 transponders, please indicate which class each transponder is for.

Quantity:

/ Rotax Class Registration (Rotax DD2, Rotax Senior, Rotax Junior) / Fees:
(Includes 1 Driver Pass, 1 Mechanic Pass, Trailer Parking / $135.00 per race / $
Rotax Class Registration (Rotax Mini-Max, Rotax Micro-Max)
(Includes 1 Driver Pass, 1 Mechanic Pass, Trailer Parking / $115.00 per race / $
Regional Class Registration (Honda Masters, Honda Senior, Honda Junior)
(Includes 1 Driver Pass, 1 Mechanic Pass, Trailer Parking / $70.00 per race / $
Pre-Event Controlled Practice / $55.00 per driver / $
Transponder Rental for both days / $25.00 per driver / $
Total Fees:

Payment:

/ Only cash or credit cards will be accepted if registering at the event
Manner of Payment:VisaMasterCard Cash
Credit Card Number:
/ Expiry Date:
Card Holder Name: / Signature:

Conditions of Entry: I/We understand the undersigned acknowledge this event is conducted in accordance with the 2011 Rotax Max Challenge Rules and Regulations, the ASN Canada FIA Canadian Karting Regulations Book 1 Sporting Regulations and Book 2 Technical Regulations, bulletins and the ECKC Supplementary Regulations and agree to abide by them. I/we certify the particulars supplied on this entry form are true and correct.

Signature of Driver: / Date:
Signature of Parent or Guardian
(if driver is under 18): / Date:

REGISTRATION INFORMATION

  1. Registration Instructions - Please read the form and the registration documents carefully. Print clearly andfill in all information requested.
  2. Eligible Entries and Licence Requirements

Residents of Canada – Canadian residents must be members in good standing of any ASN Canada FIA affiliated kart club. They may enter any ECKC Class provided they possess the appropriate license, their kart meets the appropriate technical requirements, and the driver meets the entry qualifications for their particular class.

Residents of the USA – USA residents are eligible for all ECKC Classes provided that they present a valid kart club racing license.USA residents must pay a $20.00 (CDN) associate member fee.

  1. Registration – At the event, Registrations fees must be paid by cash, debit or credit card, cheques will not be accepted. If your cheque for pre-registration is not honored by your bank, a $50.00 fee will apply
  2. Participant Info. –All participants and crew members must read and sign a waiver form. No participant will be allowed to practice on Friday until they have registered for the event.

Upon completion of all paperwork and the payment of all fees, participants will be issued documentation and passes. Lost passes for drivers may be replaced for a fee of $10.00. For crew members and guests, the replacement of the pass will be at the same price as the daily access fee of $10.00 per day.

  1. Transponder Rental– See the Supplementary Regulations regarding damage or loss of rental units.
  2. Tires– All participants are required to purchase race tires for the 2011 Eastern Canadian Karting Championship at the event. All tires will be branded with the exception of rain tires. Participants can provide their own rain tires and/or practice tires. Tires will be available for pick up the morning of each race.
  3. Tents – CallMosport International Karting.