Drag Race School Entry Applicat

City, State, Post Code _________________________________________

Home phone number __________________ Work Phone number __________________

Mobile phone number __________________ Fax number _______________________

Birth date ____________________ Height _________ Weight _________

Physical condition __________________________________________

When did you see your first drag race at a race track ? ______________

How many times have you been to a drag race ? __________________

Have you ever "lit the top bulb" on the tree ? __________ When ? ______________

What type of car ? ___________________________________________

How quick did you run ? _______________________________________

Have you ever crewed on a drag race car ? _______ Type ? ___________

If you get your license would you like to compete with your own car ? Y N

If you won the lottery what type of car would you race ? _______________

Would you make a career of driving a race car ? __________

Do you want to have your ANDRA license application endorsed Y N

Have you taken your ANDRA required physical examination ? _________

Have you applied for your ANDRA provisional license ? _________

Have you received it ? _______________

Please add any information that can assist us in your attendance at the Drag Race School

___________________________________________________________________________________

___________________________________________________________________________________

PLEASE TICK ONE BOX

5 I want the group package 5 I want the 1 on 1 package

To attend the Drag Race School you must be a licensed driver. Please include a photo copy of your driver’s license with this application.

Credit card number _______-_______-________-_________ Expiry __________

Name on credit card __________________________________

There is a printed number on the back of your credit card on the signature line.

Would you give us the last three digits of that number. __________

I agree to participate in the Drag Race School and agree to the terms of the liability waiver and approve the credit card charges for this program.

Name (print) ______________________________

Signature __________________________ Date __________________

Please fill out this form and mail or fax or email it to ken@kenlowe.com.au
If not paying by credit card you can make a deposit of $995.00 by check the check must be made out to Ken Lowe and included with this application. The balance must be paid in full at least 30 days prior to participating at the DRS.

1. Print out this page. (Ctrl+p)

2. Please fill out the form completely and return it to the Drag Race School.

3. If you don't have a credit card please include your deposit with this form.

Drag Race School
P.O. Box 132, Kingston, QLD 4114

Phone: 0411-699-535

Your pre school info packet will arrive in the mail to you.
- Confirmation letter
- Drag Race School itinerary
- Good driving rules
- Dress for success
- Guest policy
- Simplified starting line procedures
- Brake with your left foot
- Introduction to the race car
(familiarization photos with instructions)

If you have any questions about our Drag Race School please
feel free to ask at any time or write your query down below.

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