Personal Information Form

I certify that there are no mental, physical, or other conditions which prevent me from safely driving or riding in a motor vehicle on the race track, or which may endanger myself or others, and that I have had prior and appropriate experience at race tracks to make this decision, and understand the rules of operation and behavior on track and agree to abide by them, and that I have signed and agree to abide by all waivers, and that I understand that motorsports is a dangerous activity which may involve injury, death, and/or damage to mine or others property, and that if I am a driver that my vehicle is in good and safe condition and meets all current technical regulations of my club or racing organization and that I am an advanced driver in good standing. I certify that all statements made by me on this form are true and correct to the best of my knowledge and belief, and understand that any willfully false statement is sufficient cause for rejection from this and future Kojote events, and that I will be held liable to the full extent of the law for any and all consequences of such false statements.

Every entrant & every guest must fill out this form separately. All guests must be listed.