TEMPORARY LICENSE APPLICATION TO ENTER THE RESTRICTED AREA AS A DRIVER    $15.00 PER RACE

Each person must possess a Florence Motor Speedway license to enter the restricted pit area.   By signing below. I acknowledge having read, understand and voluntarily signed this application.  I agree to abide by the current rules and regulations of Florence Motor Speedway and as they may be amended from time to time. I understand and agree to accept any and all penalties, suspensions and decisions against me by officials of Florence Motor Speedway. I understand Florence Motor Speedway official's decisions are final, with no recourse or appeal. This license may be revoked at any time by Florence Motor Speedway.   Florence Motor Speedway licenses are non-transferable and must be presented at the restricted Pit sign-in area when you purchase a pit permit. You cannot purchase a general admission ticket to the restricted area. All persons 14 yrs. and older are required to possess a Florence Motor Speedway License and pit permit at all times they are in the restricted area. THIS ENTIRE LICENSE AGREEMENT IS IN EFFECT ANY TIME YOU ARE ON FLORENCE MOTOR SPEEDWAY PROPERTY.

APPLICANT'S NAME:______________________________________

STREET:_________________________________________________

CITY: __________________________________________STATE_________

ZIP CODE:_______________DATE OF BIRTH___________________

TELEPHONE(HOME) A/C_____________WORK A/C_____________

SOCIAL SECURITY # ____________________________  

E- MAIL ______________________________

RACE DIVISION: ___________________CAR/TRUCK #  ________

TEMPORARY  DRIVER  LICENSE  FEE:  $15.00  PER  RACE .

     NO MONEY WILL REFUNDED FOR “LICENSE FEE”, “PIT PERMIT FEE” OR “ANY ENTRY FEE”  FOR  ANY  POSTPONED  OR  CANCELED  EVENT!!!!

YOU MUST PROVIDE A VALID ID WITH YOUR ADDRESS & SOCIAL SECURITY #

By signing below I acknowledge that I understand motor sports racing can be a dangerous sport and the pit-infield area is restricted to participants, those persons involved with a race car or truck. I accept full responsibility for injury to myself and release Florence Motor Speedway from all liability of any injury and or property damage. Any check you may present for payment of products, pit permit fees or entry fees that is returned to Florence Motor Speedway for insufficient funds, stop payment or account closed, You will be prosecuted through the court system. 

SIGNATURE___________________________ DATE______________

SPEEDWAY OFFICIAL______________________________DATE______________