2024 Four Corners Flat Track Registration

Full Name *

Date of Birth * +

Phone Number *

Email Address *

AMA Member Number, if you need to register for an AMA number, use this link: https://americanmotorcyclist.com/ama-event-membership-form?promoterCode=FOURMC

Mailing Address *

First Class Selection: *

Bike Number *

Bike Year *

Bike Manufacturer *

Bike Model *

Second Class Selection:

Bike Number

Bike Manufacturer

Third Class Selection:

Bike Year

Bike Number

Bike Model

Bike Manufacturer

Sponsors:

Emergency Contact Name *

Emergency Contact Phone Number *

Classes are $25 for first class and $10 per additional class. AMA registration is required. *

First Class ($25.00)

Second Class ($10.00)

Third Class ($10.00)

Rally Ruffian (FREE with approval)

Current Total:

$0.00

By signing below, I acknowledge and agree to the following terms and conditions: Accuracy of Information: I certify that all information provided in this registration form is accurate to the best of my knowledge. Age Requirement: I understand that I must be 18 years of age by August 31st, 2024, to participate in the 2024 FCMR Flat Track races. AMA Membership: I acknowledge that it is mandatory to register for an AMA membership to participate in the event. Release of Liability: I hereby release and agree to hold harmless the American Motorcycle Association (AMA), La Plata County and the La Plata County Board of County Commission, Four Corners Motocycle Rally (FCMR), Podium Productions LLC, the event promoters, the owners or lessees of the premises, participants, and all officers, directors, representatives, agents, and employees associated with them, from any form of liability, loss, claims, and demands that may arise from any loss, damage, or injury (including death) to my person or property. This release applies to any FCMR event, including but not limited to competitions, practices, or preparation activities, and extends to incidents occurring upon entering or departing from said premises. Assumption of Risk: I acknowledge the inherent risks and dangers associated with participating in FCMR/AMA events, and I voluntarily assume all risks for loss, damage, or injury (including death) to myself and my property from any cause whatsoever. Acknowledgment of Release: I have read and understand the above release from liability. Sportsmanship Pledge: I agree to hold myself and my family accountable to the 2024 Sportsmanship Pledge and all other FCMR/AMA sanctioned rules available in the rule book. I understand that this is a family event. *

clear