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Watkins Glen Track Event
Wednesday, April 29th and Thursday, April 30th, 2015
Registration Fee:
FCA members: $690
Non-Members: $775 (save $, join the FCA)
Name:
Emergency Contact:
Address:
Emergency Contact Phone #:
City/State/Zip:
FCA Membership #:
Cell #:
Guest Names (required by WGI for entry):
Garage (limited availability): $75
Email:
Total Enclosed (please make check payable to FCA-ESR): $
Car Model:
Year:
Color:
Permanent #:
Event Sponsor: Classic Coach.
I have driven at a previous FCA WGI event :
Signature*** (Required):
Drivers Meeting 7:45 AM (Mandatory)
Green (Novice w/instructor)
White (solo)
Blue (intermediate)
Red (experienced)
***I hereby certify that I have no physical or health conditions that would render me unable to withstand the rigors of driving on a racetrack or that might otherwise jeopardize
other people on the track. I will have completed the pre event Tech Inspection on the car listed above within 14 days of the event.
(Please see www.empirestateregion.com for a list of inspection facilities and official FCA Tech Inspection Form.
Questions? Contact Bob Coates: 201-755-6000 (evenings only or rc@parawire.com)
Please send completed form with signature and check (payable to FCA-ESR) to: Bob Coates, 42 Sea Gate Road, Staten Island, NY 10305.