I, the undersigned, hereby apply for membership to Monoposto Racing (MR) a division of Monoposto Register, Inc. I agree to be bound by and adhere to the General Competition Rules and Regulations of Monoposto Racing.

	I certify that the information given is correct.
	In consideration of my being granted membership, I acknowledge and accept:
(a)	that certain risks are inherent in car race events and that by participating in such events I voluntarily run the risk of injury or loss of life; and,
(b)	that it is a condition of my becoming an MR member I assume all such risks myself; and
(c)	that I acknowledge and accept MR Rules and Regulations and the enforcement of these Rules and Regulations, even if such enforcement effects my qualifications to race in MR events.

I for myself, my heirs, executors, and administrators hereby release and forever discharge Monoposto Racing, the owners, sponsors, and drivers of other cars participating with me in any such event, the owners and occupiers of the premises on which any such event is run and all those having anything to do with the management or control of such premises or of the competing cars and service vehicles or of the event itself, their agents, of and from any and all actions, causes of action, claims and demands whatsoever for any loss or injury suffered by me in any way arising out of, or resulting from, my participating in any such event, test, or practice therefor, or from my being on such premises for, or in connection with, any event in which it is intended that I or my car participate, whether or not such loss or injury results wholly or partly from negligence on the part of any of the persons hereby released and I undertake not to use any drug considered illegal.

If applicant is under the legal age of Majority, a "Consent and Release by Parent or Guardian" form must accompany this application.

______________________________ Signature

______________________________ Date