Ten days prior to all lapping programs, email reminder will be sent including schedule, driver guidelines, car prep, and cancellation policy etc. All programs conducted rain or shine.

Once submitted, please call 253-630-5130. This line is monitored daily so please feel free to leave your bank card number and other sensitive information on this secure line. You will be contacted by e-mail once your information is on file.
Name: Address:
City: State:
Zip:
Hm. Phone # (include area code) Wk. Phone # (include area code)
E-Mail Address:
Driver’s License# (we can see this info. day of course)
*Age: *Driver under 18 years of age must have a liability release signed by parent or legal guardian. State: Expiration:
*Car you will be driving? (year,make,model)
*All convertibles require fixed roll-over protection or DOT approved manufacturer's roll-over the device.
RETURNING DRIVERS: please list ProFormance, other Driving Clubs, and Pacific Raceways experience including last driving event.
Credit Card Name: Expiry Month: Expiry Year: (or include this info with your voicemail)
Credit Card Number: (Call 253-630-5130) _______________________________________________________
MEDICAL INFORMATION:
Date of Birth: (month, day, year) (include this info with your voicemail)
Blood Type: (if known) if known
Date or year of last Tetanus: if known
Prescription Medications: (please list )
Special Medical Conditions: (please list)
Dentures: Asthmatic: Diabetic: Epileptic: Hemophiliac:
Hearing Impaired: Hypertension: (please indicate yes or no on all)
Allergies: (please list)
Primary Physician: Telephone (area code)
City:
HEALTH INSURANCE INFORMATION:
Carrier:
Group Name: include this info with your voicemail)
EMERGENCY CONTACT:
Name: Relation:
Phone (area code) City:

This is not competition driving, This is a high speed driving school, on a racetrack, under close supervision by instructors. While the overriding consideration during the operation of the event is safety, incidents may occur that could cause vehicle damage and/or personal injury. You will be driving in a class session with other students and instructors whose vehicles may be uninsured and/or unregistered.

You are totally responsible for the safe operation and safe mechanical condition of your vehicle. ProFormance Racing School, it's instructors, staff, and facility providers assume no responsibility in the event of an incident, of any kind, in the course of these events.

Submission of this application is your acknowledgment of the above and agreement to attend under these conditions.
Type-in your Name Here: Date: (include month, day, year)

Please Note: This form is submitted to ProFormance Racing school as standard e-mail. Please do not include information such as, credit card numbers, passwords, ID Numbers, or any information that requires security encyption. 
Cancellations: We require 14 days notice of cancellation. Failure to notify our office, either by telephone or writing, prior to 14 days of your reserved school date will result in forfeiture of your deposit. Payment in full required 7 days prior to scheduled program. No refunds are given for cancellation less than 7 days from scheduled date. Prices subject to change without notice. Sorry, but some restrictions may apply.
   

If you do not hear from us within 24 hours, please call us at 253-630-5130 or fax your form to 425-271-7232.

Contact
Don Kitch Jr.
ProFormance Racing School
(253)-630-5130
Fax (425)-271-7232