2019 Janet Watkins Memorial Pulmonary Fibrosis Awareness 250 Entry Form

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Your Name *

Your Name as it appears on iRacing Account *

Your iRacing Account Number *

Your Email Address *

City, State *

Your Birthdate *

YYYY

Team Name *

You can enter yourself as the team owner if you are not entering the event as part of a team

1st Car Number Choice *

Only #'s 00-199 permitted

2nd Car Number Choice *

Only #'s 00-199 permitted

How did you find out about this event? *

This event carries a non refundable entry fee of $10.00 USD. You will receive an email with instructions on how to make that payment. *

Paypal is our preferred payment method, you can use a credit or debit card without creating an account via Paypal.com

Yes, I accept

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By submitting this application for competition in the American Sim Racing Series, I agree to hold harmless the American Sim Racing Series, owners, staff, competitors, sponsors, or any persons involved with the racing league. I hereby acknowledge the rules set forth by the American Sim Racing Series and agree to abide by those rules. I hereby waive all rights to hold the American Sim Racing Series responsible for any damages occurring as a result of my participation in the American Sim Racing Series. *

I have read the rules and agree to abide by them. I hereby release the use of my name, car number, team name, associated logos, and photos in any media used by the American Sim Racing Series.

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