2009 Tri-C Membership Application
2009 Tri-C Karters Club Membership Application (Membership valid from January1 through December 31, 2009)
Membership Fees for 2009: The club will follow a similar membership program established by IKF. Tri-C Karters member must be by a person 18 years of age or older. All drivers that are minors (under the age of 18) must be signed up as a family member by a parent or legal guardian who is a Club Member and submit an IKF Minor Release Form (Waiver of Liability). Only minors age 5 or older may sign up as a family member.
Club Membership $60, Family Membership $10 each
Club Member Information (must be 18 years of age or older):
First Name____________________ Last Name______________________________________
Address: ___________________________ City: _____________________Zip Code________
Day time Phone: (____) ______________ (or) Evening Phone: (_____) __________________
Email __________________________________ Birth Date _____/_____/_____ Age: ______
Race Class 1 Name: ______________________ Driver Name: _________________________
Kart Number: 1st choice _____ 2nd choice ____
Race Class 2 Name: ______________________ Driver Name: _________________________
Kart Number: 1st choice _____ 2nd choice ____
Race Class 3 Name: ______________________ Driver Name: _________________________
Kart Number: 1st choice _____ 2nd choice ____
(See www.tri-ckarters.com for correct race class name.)
Club Member signature _____________________________________ Date ___/___/______
Family Membership Information*(drivers must be at least 5 years of age or older, family members cannot vote, only one club newsletter will be sent per address):
Do family members have same address as Club Member? Yes___ (skip to name info) No ____
Address: __________________________ City: ______________________Zip Code________
Day time Phone: (____) _______________ (or) Evening Phone: (_____) _________________
Name______________________________________Birth Date ____/____/_____Age:______
Name______________________________________Birth Date ____/____/_____Age:______
Name______________________________________Birth Date ____/____/_____Age:______
*If under the age of 18, (A New Minor release form must be completed and submitted for the 2009 race season.) (Kid Kart drivers must have proof of age document available at their first race event.)
Father Signature_______________________________________Date___/__/__
(Signature required if driver is under age 18)
Mother Signature_______________________________________Date___/__/__
(Signature required if driver is under age 18)
Guardian Signature _____________________________________Date __/___/___
(Signature required if driver is under age 18)
Signature(s) recorded above agrees to abide by the by-laws and rules of the Tri-C Karters Club and the International Kart Federation (IKF)
IN ORDER TO BEGIN ACCUMULATING SEASON POINTS, YOUR MEMBERSHIP APPLICATION MUST BE RECEIVED PRIOR THE DRIVERS MEETING OF THAT RACE. YOU WILL NOT ACCUMULATE ANY POINTS FOR PARTICIPATION IN ANY RACES PRIOR TO TRI-C KARTERS RECEIVING YOUR APPLICATION.
Make checks payable to Tri-C Karters. Please mail completed application and check to:
Rosie Stanway
47675 Tulip Place
Indio, CA 92201
Note: If you do not receive your Tri-C Karters membership card within 10 days, please contact Rosie Stanway at
760-296-3594 or Rstanwayii@Yahoo.com
(Office Use Only)
Membership approved by: ______________________________ Date approved: _________
Membership Card Number: _______ _____________________ Card Issue Date: _________