NEVADA OLD TIMERS

31stANNUAL INTERNATIONAL MOTO-X

LABOR DAY WEEKEND, September3rd & 4th, 2011

Fernley International Raceway Fernley, Nevada

Name______

Age______Number on Bike ______Chapter______

Address______

City______State______Zip______

Make of Bike______E-mail______Phone______

T-Shirt Size______Extra Dinners at $10.00 each ______Amount Enclosed $______

OLD TIMERS ONLY PLEASECHECK YOUR CLASS No 1 day entries accepted

+30 Old Timers would like to see a OTMX chapter membership card. Join at the track.

Support classes are $20.00 per day. Entry required for each day. Trophies awarded for each day.

SUPPORT ONLY
SAT SUN
Circle one / +30 A Sportsman A All 85cc
+30B Sportsman B All 65cc/50cc

Riders who do not have the proper background will be docked a lap for each moto they ride with the wrong color background.

Novices – Green Amateurs – Yellow Experts - White Masters – Black

Be prepared to show your Chapters’ OTMX membership card at check-in/Sign-up

Old Timer Classes Are $85.00 - Pre-Entry OR Post-Entry

+60 Novice & All +70 riders pay only $75. +80 Riders are FREE!

Ride a SECOND Old Timer Class for just $40

First 100 Pre-Entries Receive A FREE T-Shirt.

$10 Gate Fee per personor $20 per car-loadfor the weekend. Under 10 years old are FREE.

Additional Dinners Are $10.00 Each.

Free Camping At Track. No Hook-Ups.

Enter the “Jackpot Drawing”,“Crap Shoot” and “Slow Race” On Saturday Night.

Mail to: Bob Fabel

Make checks payable to NEVADA OTMX 1721 Rice Rd

Fallon, NV 89406

Information: 775-423-8226 after 6:00 pm or or

I hereby acknowledge that I am aware of the dangers incident to this event and knowingly enter this event with said knowledge. I further acknowledge that I am aware of the fact that any injuries or damages sustained by me due to my participation in this event may be of a permanent and grave nature and I nevertheless, voluntarily and knowingly enter said event. I further acknowledge that during the course of said event that there may be times at which through not actively participating in said event, I may be a spectator and that I may sustain permanent or grave injuries as a spectator and I, nevertheless, voluntarily and knowingly assume such risk. I further acknowledge that I may sustain permanent or grave injuries as either a participant or spectator at this event due to the negligence of other persons including participants, the contest committee, the sponsoring club, the referee, or other official, the owners of the premises, or any of the leasers and with this in mind, I nevertheless, voluntarily and knowingly assume such risk and promise to hold no one other than myself responsible for any injury or property damage incurred for any reason while spectating or participating at this event.

THERE IS NO RIDER OR SPECTATOR INSURANCE PROVIDED. I PROMISE TO PAY FOR ALL EMERGENCY MEDICAL ASSISTANCE PROVIDED INCLUDING AMBULANCE TRANSPORTATION WHERE DEEMED REQUIRED. I HAVE READ THIS ENTRY AND AGREE TO STATED CONDITIONS.

Rider’s Signature______Date______

Parents Signature for riders under 18______