Mail Certificate?

Yes

No

Will there be a Doctor/EMT on duty?

Yes

No

Ambulance?

Yes

No

Fire Inspector?

Yes

No

Qualified Vehicle Inspector?

Yes

No

Does this track/course include the use of public roads or highways?

Yes

No

Each scheduled event must be reported at a minimum of 48 hours prior to actual day on which the scheduled event or events are to take place, and premium must be paid at the time of the report as evidenced by United States or Canadian postmark. There are no exceptions to this rule. *

ACKNOWLEDGE

In the event of a rain-out/snow-out, or if the race is postponed for any reason, notify Frazier Insurance Agency immediately with the reason. Also indicate whether the premium is to be returned or credited to your next race date. Once you have started your event, and will not honor ticket delays to the next event, your premium is fully earned. *

ACKNOWLEDGE

A check for payment of premium that is returned marked "insufficient funds" will negate coverage and requires further transactions to be paid by either certified check or cashier's check.

ACKNOWLEDGE

AGREEMENTS

a. Each event shall be conducted in compliance with the most current competition rules. b. Precautions must be taken to restrain unauthorized persons from being on the race course. c. The promoter must provide adequate barriers, fencing, and other means of crowd control. Ropes and banners are unacceptable. d. The promoter must display a notice stating "Spectators witnessing these events hereby assume all for injuries or damages resulting therefrom." e. The promoter shall supply a sufficient number of police/security to maintain crowd control. The details and data supplied in this enrollment form are warranted to be true and correct and become the equal consideration with the premium paid for which the policy of insurance is issued.

AFFIRMED