SCCLAC/LOL SCCA/WAG
Wisconsin Glacier Trails VII Entry Form
 Saturday, May 4, 2002

Driver _________________________________ Navigator ______________________________
Address _______________________________ Address _______________________________
City/State/Zip____________________________ City/State/Zip____________________________
Phone _(______)_________________________ Phone _(______)_________________________
E-Mail_________________________________ E-Mail_________________________________
Region/Number _________________________ Region/Number _________________________
Lifetime Points?   Y       N          Minor?  Y      N Lifetime Points?   Y       N          Minor?  Y      N
In case of Emergency, notify: In case of Emergency, notify:
Name _________________________________ Name _________________________________
Phone _(______)_________________________ Phone _(______)_________________________
Drivers' License # ___________________________________ State _____
Vehicle Year, Make, Model _________________________________________________________
Color _______________  License ___________ State _____ Insurance Co. ___________________

Class Entered (please circle)      EQUIPPED        LIMITED        STOCK      ROOKIE      VINTAGE

Circle the Event(s) You Are Entering:      NATIONAL        DIVISIONAL

I hereby warrant that the above vehicle is on the road legally, is being used by the entrant with the owner's permission, and is covered by liability insurance of not less than $20,000/$40,000/$10,000, or the minimum requirements in the state of registry, whichever is higher.  I further warrant that the vehicle is in safe operating condition and that the safety items listed below have been checked and are in good working order.

Entrant/Owner's signature ________________________________

We have reviewed Art. 11d [Class R], and hereby warrant we (check one) [  ] do [  ] do not qualify for Rookie Class.
The driver warrants that she/he is in possession of a valid operators license.

Driver's Signature________________________ Navigator's Signature______________________

How did you learn about this event? ___________________________________________________

Entry Fee ___________ Paid ______________ Date Rec'd __________ Generals Mailed ______

VEHICLE INSPECTION

The following items must be in proper working order:
____ Headlights (High/Low beams) ____ Foot Brake
____ Parking, tail, directional and stop lamps ____ Parking Brake
____ Horn ____ Tires (condition of sidewall and tread)
____ Windshield wipers and washers ____ Seat belts (securely installed for driver 
____ Rear view mirrors                                  and all passengers)

Send completed signed entry form & fees to Registrar: Fred Rosevear, 5013 Lake Mendota Dr., Madison, WI  53705.  Make checks payable to SCCLAC.  Note: All return communication (Generals, Entry Lists, Results) will be by e-mail.