04 North 150 West Phone (208) 734-3700

Jerome, ID 83338 FAX 208-324-2140

MAGIC VALLEY SPEEDWAY MEMBERSHIP FORM 2009

The acceptance of this application and fee by any Magic Valley Speedway

Official and the depositing of accompanying funds by any Magic Valley Speedway Official,

does not constitute approval of this application. Applications may only be approved by

Magic Valley Speedway headquarters. By signing this Magic Valley Speedway membership

application, you are signing for a local membership only. You will also be required

to carefully read and sign a Consent and Release of Liability form, before being permitted

to enter any restricted area. By signing this membership application you are assuming all

responsibility for money received as a result of your activities including, without

eliminating, income tax, FICA, Workmen’s Compensation and withholding taxes. You are

agreeing that you are not an employee, servant or agent of the Speedway. By signing this

membership application you agree to abide by all rules and regulations of the Magic Valley

Speedway now published or hereinafter modified. By signing this membership agreement you

give consent to the use of his/her name, pictures of him/herself and his/her car for

publicity, advertising and endorsements both before and after the events, and relinquished

any rights to photos taken in connection with events and consents to the publication or

sale of such photos as the Magic Valley Speedway so desires. Any controversy or claim

arising out of or relating to this agreement, including any agrees to accept the decision

rendered by this process. The undersign has read and voluntarily signs the Magic Valley

Speedway Membership Application and further agrees that no oral representations, statements

or inducements apart from the foregoing written agreement have been made in exchange for

admittance to restricted areas. By signing the release waiver, you have waived legal rights

to sue for injuries, including death, and acknowledge the potentially dangerous nature of

activities in and adjacent to restricted areas. I have read and fully understand this

agreement. I agree to abide by all the terms of

this agreement and the rules of Magic Valley Speedway.

Signature______

Your Car Number from 2008 is yours till February 28th of 2009.

Car Number: #1: ______#2:______Pad is yours when the class you buy it for is

racing; Fall Classic not included. Pads will be distributed 3-2-09 by date pad is bought and

2008 point standings.An online pad map will be used.Driver membership with concrete

padCircle class Late Models $250 Mods $225 SuperStocks $225 Pony Stocks $225

Trucks $225 Streetstocks $200 Supersixes $175

Driver Membership no concrete pads Hornets $100.00 Junior Stinger ($0.00)

Circle Crew Membership Late Model, Mods, Superstock, Ponystock, Streetstock, Hornet, Junior Stingers

Supersixes, Trucks All crew members: $85.00/each

PLEASE PRINT

Applicant’s Name:______

Address:______

City: ______State: ______Zip: ______

Phone Number: ______Cell Number: ______

Fax Number: ______SS Number: ______

E-mail Address: ______

Date of Birth: ______Current Age: ______

In Case of Emergency Notify: ______Relationship: ______Total Amount Enclosed______