Antrim Home & Harvest Celebration Soapbox Derby

 Sponsored by the Antrim Chamber of Commerce

Annual Soap Box Derby September 22^th 2007 – Registration Form

Car Safety Inspection 8:30 am, Grea Brook Middle School School Parking Lot

Race begins at 9 a.m.   Prizes awarded at the conclusion of the race.

 

Name:  ___________________________________________   Age:  _____________________

 

Address:  _________________________________________   Phone:  ___________________

 

I understand that participating in this race could result in injury and hereby give permission for my child ___________________________ to participate in this event.  I agree to indemnify and hold blameless, the Town of Antrim, the Antrim Police Department, The Antrim Chamber of Commerce, the race sponsors and the race organizers for any injuries or damage incurred by participation in this event.  In addition, I inspected the finished derby vehicle to ensure it is safe and meets with race requirements.

 

Parent/Guardian Signature:  ________________________________          Date:  ____________

 

 

Print Name & Emergency Contact Info:  _____________________________________________

 

Race Rules

 

1.                A completed entry form is required for all racers.

2.                All derby cars must be equipped with brake or stopping device.

3.                All seats must be securely attached to the frame of the derby car

4.                All participants must wear a helmet and use a seat belt

5.                No motors or other sources of mechanical power allowed

6.                No heavy items may be attached to the vehicle for the sole purpose         of adding weight

7.                Only 1 occupant per vehicle

8.                All racers are to assemble at 11:00 a.m. at the Town Basketball/Skateboard park for registration, vehicle inspection and race instruction

For additional information, contact Brian Beihl, Antrim Chamber of Commerce,

588-8300 W or 588-3014 H