12 Hour Karting Race Entry Form

Team Details

All Drivers and Team members are to abide to the Rules and Regulations ruling this event. If any
part is not clear, the Race Director will be more than happy to explain during the briefing session.

The team participation will be provided only upon payment settlement.

By completing and submitting this online entry form, you are stating that you hereby agree to follow Victory Lane Karting’s track rules and confirm to the best of my knowledge that the information provided herewith is correct and the Organizers will not be held responsible for any wrong information provided by the team.

This is an electronic entry form. Your entry will not be complete until you settle payment and sign the entry form at Victory Lane Karting. You can also download this form here.

Please enter the email address of the person filling out this form:

Team Name
             
Choose the name your team will go by during the race and all racing events associated with 12 Hours of Charlotte 2012:
         
Team Name:        
       
             
1. Team Captain Details
             
Full Name:
    
DOB:
  
Email:
    
Height:
  
Cell #:
    
Weight:
  
             
2. Other Driver Details
             
Full Name:
    
DOB:
  
Email:
    
Height:
  
Cell #:
    
Weight:
  
             
3. Other Driver Details
             
Full Name:
    
DOB:
  
Email:
    
Height:
  
Cell #:
    
Weight:
  
             
4. Other Driver Details
             
Full Name:
    
DOB:
  
Email:
    
Height:
  
Cell #:
    
Weight:
  
             
5. Other Driver Details
             
Full Name:
    
DOB:
  
Email:
    
Height:
  
Cell #:
    
Weight:
  
             
6. Other Driver Details
             
Full Name:
    
DOB:
  
Email:
    
Height:
  
Cell #:
    
Weight:
  
             
Use the box below to include a message to Victory Lane Karting:
             
This is an electronic entry form. Your entry will not be complete until you settle payment and sign the entry form at Victory Lane Karting.