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St. Petersburg Grand Prix Entry Form

Mar 22-24, 2013

EmailMeForm

Driver *
Prefix First Last Suffix
Driver must hold a competition license with HSR or VMC recognized organization’s competiton license with a valid medical date. Must include a copy of VMC recognized license with entry.
HSR Member #
Other Racing Org/Member #

Use this field if not and HSR member
Email *
Phone *
### - ### - ####
Address *

Street Address City State / Province / Region Postal / Zip Code Country
Co-Driver
First Last
Co-Driver HSR Member #
Co-Driver Email
Car Information
Year
Make
Model
Color
Displacement (in litres)
AMB Transponder #
FIA Car
Slick Tires
Car Number Preference
(must choose 3) *
*
*
Crew Information

Entry includes Driver and 3 crew spaces. Driver and Co-Driver uses a crew space. All Crew with an Annual Crew card use a crew space at every event whether they are present or not. Overcrew tickets are $45 each.
Crew 1
Crew 2
Crew 3
Event Fees

Race Entry includes 4 racing credentials. Please check each event you wish to participate in. Must enter Race Entry. ENTRY DEADLINE MARCH 8, 2013.
Race Entry

Fee- $995

No Entry - $0

Includes Fri, Sat, Sun sessions
Number of Overcrew
($105/ea)
Rig Size (Length)

(Ft)
Rig Size (Width)

(Ft)
Tow Vehichle Type

(Ft)
Tow Vehichle Size (Length)

(Ft)
Tow Vehichle Size (Width)

(Ft)
Amount of Entry
$ Dollars . Cents
Total Amount Enclosed *
$ Dollars . Cents
Credit Card
Credit Card Number

*SSL Enabled
Credit Card VIN

3 Digits
Credit Card Exp Date XX/XX
Check Number

Make Checks payable to HSR
Mail Entry and payment to HSR
1005 Parkway Ind. Park Dr.
Buford, GA 30518
404 298-5616 (404) 298-6376 - Fax
www.hsrrace.com - email: judy@hsrrace.com
HSR Rules

The applicant (including crew, driver and car owner) agrees to conform to the rules, procedures and policies of HSR and waives any right to claim against, and covenants not to sue HSR, its officers, directors, employees, agents or any drivers’ committee with respect to the interpretation or application of any rules, procedures or policies.
Transponders

AMB Transponders are mandatory, To purchase or rent an AMB Transponder, please contact Janet Harhay, jharhay@aol.com. Transponder purchase/rental form can be found on the HSR website under “forms”.
Cancellations

In case of entry cancellation, due to the nature of this event, no credits or refunds will be made of entry fee.
Additional Information
Section Break

A description of the section goes here.

Car Information

Crew Information

Event Fees

HSR Rules

Transponders

Cancellations

Section Break