3rd Annual ACE Race Team Registration
In addition to this form, please officially register for membership with Electrathon America at https://docs.wixstatic.com/ugd/032d61_f619bd527f0e48e1baa710cf4c9a2280.pdf
Email address *
Primary Advisory *
Your answer
Primary Advisor's Phone *
Your answer
School Name *
Your answer
Mailing Address (Street) *
Your answer
City, State, Zip *
Your answer
Advisors:
Signing this registration form demonstrates your commitment to abide by the rules and regulations established by Electrathon America and Alamo City Electrathon. You also signify the following:
Are your team members knowledgeable of the Electrathon America rules for 2019? *
Your team members and advisors will maintain a professional relationship with each other, their colleagues, and ACE Race personnel by recognizing and promoting the following (Check All): *
Required
You have attached a copy of your team’s current Electrathon America registration for each car entered for the current race? *
Your team has attached a team listing. ALL team members including advisors, parents, etc. will sign a waiver from the race insurance carrier (K & K Insurance) prior to entering the track infield. *
Each driver has attached a ACE Race Driver Medical Authorization, Release and Liability Waiver Form. The race insurance carrier may requirement a separate waiver for drivers as well where the original race form must be used as well. *
Team Advisor Names & Emails *
Your answer
Student Team Member Names & Ages (10 Max) *
Your answer
DRIVER MEDICAL AUTHORIZATION, RELEASE, & LIABILITY WAIVER
You must read this form and sign it before participating in any Alamo City Electrathon events during the year 2018. If you are under the age of 18, you must also have a parent or legal guardian read and sign this form. To drive you must be 16 years of age or older and possess a valid driver’s license.

I, the undersigned, voluntarily agree to the following:
•The participant is participating in each Alamo City Electrathon event under their own free will, and the Parent/guardian (if participant is under 18) approves of such participation.
•I am personally responsible for my actions, and I shall conduct myself with proper sportsmanship.
•I shall abide by the rules, conditions, guidelines, and decisions of Electrathon America and race/event officials. I understand this is a non-professional program/event, and changes, delays, and/or errors may occur.
•I understand that the activities of the event are dangerous and involve risk; I accept the conditions under which each of the events is held; and I accept and assume all risks inherent in each of these competition events, including injury (fatal or otherwise) and property loss/damage, and including those that I may not foresee or anticipate.
•I agree to assume all costs related to any medical treatment; I authorize my insurance company to pay benefits for the costs of such treatment; I also authorize the disclosure of medical information to my insurance company for the purpose of any claim;
•I understand each participant must provide her/his own medical insurance; I also understand that I am responsible for any medical or other charges related to participation in the Alamo City Electrathon event(s).
•I give my consent for medical treatment, and permission to event personnel to supervise or perform on-site first- aid for minor injuries and to a licensed physician to hospitalize and secure proper treatment (including Injections, anesthesia, surgery, or other reasonable and necessary procedures) for the participant (If you wish to limit medical treatment, draw a line through it or add your comments.
•I hereby release, hold harmless, and agree to indemnify the South San Antonio Chamber of Commerce, Toyota Motor Manufacturing Texas, Electrathon America, Board of Regents/State of Texas, State of Texas, track owner(s), event sponsors, organizers, officials, volunteers, and other people and organizations or entities associated with the event (RELEASEES) from any and all liability, whether injury is caused by my negligence, the negligence of RELEASEES or the negligence of any third party, and agree to settle any and all disputes through established event rules and procedures

READ CAREFULLY BEFORE SIGNING.
THIS IS A RELEASE OF YOUR RIGHTS.

I have read the entire Medical Authorization, Release, & Liability Waiver, I fully understand it, and I agree to be legally bound by it. *
Name Of Signing Advisor *
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of South San Antonio Chamber. Report Abuse - Terms of Service