Iron County Fair
             
August 17, 2019
Iron County Fairgrounds in Parowan, Utah


Registration: 2 pm - 5 pm No late entries
Driver's Meeting: 6:00 pm
Heats: Depending on number of entrants, there will either be 1 or 2 runs. If there are 2 runs, they will go in reverse order.
One pit person is allowed with a paid entry fee.

Driver's Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone: Email:
(Please make sure this is your mailing address)

 
Sponsored By

Vehicle Color
Vehicle Year
Vehicle Make
Vehicle Model
Class

Entry Fee Per Run:   $30.00   Item Subtotal:  
$30.00
Total:
$30.00
 
Adult Indemnification Form
As the above driver, I have read and agree to follow all the rules of the Iron County Fail and its officials. The undersigned, being of adult age, do understand that the Mud Bug Race is an extreme sport and in consideration of his/her participation in the Mud Bog Race conducted by The Iron County Fair, does expressly assume all risk and hazards from the activity.

The undersigned does hereby waive, release, absolve, and indemnify and agree to hold harmless, The Iron County Fair, Parowan City, ICF sponsors, officials, and other participants from any claim arising out of an injury that may occur to him/her.


I Agree
I have read and agree to the statements above.

Pit Crew
I the undersigned, being of adult age, do understand that all classes in the Mud Bog Races are an extreme sport and in consideration of his/her participation in the Mud Bog Races conducted by The Iron County Fair, does expressly assume all risk and hazards from the activity.
The undersigned does hereby waive, release, absolve, and indemnify and agree to hold harmless, The Iron County Fair, Parowan City, ICF sponsors, officials and other participants from any claim arising out of an injury that may occur to him/her.
 
Pit Crew Member

Parental Authorization for Minors
We, the parents and/or guardians of the applicant driver, do understand that the Mud Bog Race is an extreme sport, hereby give our consent to his/her participation in the Mud Bog Race conducted by The Iron County Fair.

We assume all risk and hazards from the activity: and we do hereby waive, release, absolve, indemnify, and agree to hold harmless The Iron County Fair, Parowan City, ICF sponsors, officials, and other participants from any claim arising out of an injury that may occur to our son/daughter.

We Agree
We have read and agree to the statements above.
Father's Name
Mother's Name

Payment Information
Method of Payment:
Processing Fees: Credit cards: 2.5% ($1.50 min)
                    (+1.5% processing fee for foreign cards)
eChecks: $0.49
Update name from Driver's Information
Name of Individual
on Checking Account:
Name of Individual
on Savings Account:
Name of Business
on Checking Account:
Bank Routing Number:
Bank Account Number:
Credit Card Number: (Type number or swipe with cursor in this empty field)
Expiration Date: /
Card ID (CVV2/CID) Number: What is the Card ID?
Cardholder Information (exactly as it appears on your statement)
  Update from Driver's Information
Cardholder's Name:
Billing ZIP/Postal Code:
For More Information
Call Iron County Fair (435) 477-8380
email-fair@ironcounty.net

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