4th Annual Springlake Derby - Race Registration and Waiver

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Excited for this year's Springlake Derby? Save your spot by filling out this form. If under the age of 18, a Parent or Legal Guardian will need to sign a liability release waiver included in this form. This form is also used to register your derby car and guage neighborhood participation in this year's event.

The Springlake Derby is an event for all ages, by filling out this form you are enabling our planning to make this year "a year to remember". The Derby is funded by the Springlake Civic Association in partnership with Friends of Springlake Park and the Springlake Garden Club. The event is a total community event run by Springlake for Springlake. We welcome all Springlake residents and friends to partake in this year's Derby! It's going to be a fun one! Cheers, The Derby Committee

Email *

Full Name *

Please provide the full name of the person filling out this Registration and Waiver. If under the age of 18, please pause and have your parent or legal gaurdian (18 years or older) fill out this form. A parent or legal gaurdian can sign for no more than 2 drivers per form. Each Adult (18 years or older) will need to fill out their own respective Registration and Waiver.

Phone number

Address

Do you plan on racing or registering a car for you or your child/minor? *

Yes

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