PARENT CONTACT INFORMATION
   
First Name: *
Last Name: *
Address: *
City: *
State: *
Zip: *
Email: *
Day Phone:
Evening Phone:
Date of Birth: *
  
By checking this box, the Entrant has my consent and permission to items 1-4 below: *
   

1. Enter and participate in the Ultimate Kids Club Member Sweepstakes at Richmond International Raceway (“Sweepstakes”). I acknowledge that I have read and understand the attached Sweepstake Rules, and that I and the Entrant will be bound by these Official Rules.

2. Allow the Entrant’s name and age to be displayed on website if selected as winner.

3. I confirm that the Entrant is a citizen or legal permanent resident of the United States and will report any prize winnings to all relevant federal, state, and local tax authorities.

4. Privacy Disclaimer: Any personal information collected during the course of the Sweepstakes by Sponsor will be used for administering this competition, or as otherwise set out in the Official Rules. Except where prohibited by law, participation in the Sweepstakes constitutes the Entrant’s and his or her parent’s/legal guardian’s consent to the storage, use and disclosure of the Entrant’s entry details as set out in the Sweepstake Rules.

   
 
   
CHILD INFORMATION
   
Child's first name ("Entrant"): *
Child's last name ("Entrant"): *
Child's date of birth: *
Child's favorite driver: