Beginners Program – Bear Creek Raceway Park

Drivers Name:*

Drivers Driving Experience (Electric bikes, electric scooters, karts, etc.): *

Does the driver have any of the following safety equipment (check all that apply) :*

Helmet

Neck Brace

Racing/leather/Type Jacket

Drivers Age:*

Drivers Height:*

Drivers Headband Size/Hat Size:*

Drivers Waistline Measurements*

(Measured straight across hip to hip. This helps to determine seat size)

Parents/Guardian Name:

Best phone number to reach you at?

Email address*

Business Email*