SOW6 MEMBERSHIP APPLICATION SOUTHERN OUTLAW WING 600’S MEMBERSHIP AND COMPETITION LICENSE FORM THE UNDERSIGNED HEREBY APPLIES FOR THE CLASSIFICATIONS OF MEMBERSHIP First Name: _______________________ MI: ___ Last Name___________________________ Nickname: _________________________ Car #: ________ Year Racing: _____ Address:________________________ City: ____________________State: _______ Zip: __________ Home #: ________________ Work #: _________________ Cell #: _______________ DOB: ______________ SSN #: ___________________ Occupation: ___________________ Emergency Contact ____________________________  Phone # _________________ E-Mail # _____________________________ RELEASE OF LIABILITY The undersigned owner/driver, by signing this application does agree to assume all responsibility and liability for all acts or activities of said owner and of any and all his drivers, assistants, and crew, and for any and all damage or injury that may be caused by any or all of them or by his car or other property or possessions. The said owner does hereby release the Southern Outlaw Wing 600 and any organization sponsoring or assisting in promoting or conducting a race sanction by the said association, together with their successors, assigns, officers, agents, assistants, representatives, employees, and spectators attending said race from any and all liability claims, demands, and causes of action whatsoever, which the owner may have or may accrue in his favor, against them or any of them in any way growing out of or resulting from said race or any part thereof or in connection with any equipment or facility provided or used whether or not same may be operated or controlled by them or whether arising from damage of the person and property of himself, his driver and assistants whether caused by negligence or otherwise, and said owner agrees that no other agreement whether oral or written shall in any way affect this release. Furthermore, said owner, certifies to the truth of all statements in the application – said owner agrees to abide by all the rules and to accept the final decisions of properly authorized race officials. Signature: ________________________ Date: ___________ Paid: Cash/Ck#__________ If applicant is under 18 years of age, parents or legal guardian must sign. Signature of Parent or Guardian (if applicable) Signature: _________________________________________ Date: _____________________ By signing the above form, I acknowledge that I am releasing my rights to sue, prosecute, and to hold harmless the club, tracks, other racers and anyone associated with the Southern Outlaw Wing 600 Racing Association.