I hereby certify that I am an independent contractor, assuming all responsibility for moneys received as a result of my participation in BAPS Motor Speedway events, including without eliminating, income taxes, FICA, workmen’s compensation and withholding taxes. I am not a employee, servant or agent of BAPS Motor Speedway. In consideration of acceptance by speedway of this entry form and payment of entry fees, the undersigned agrees to abide by all rules and regulations of BAPS Motor Speedway as to conduct and mechanical specifications, as now published for this event or hereafter modified.

The undersigned consents to the use of his/her name and/or pictures of himself/herself and his/her car, for publicity, advertising, endorsements, both before and after BAPS Motor Speedway events and relinquish all rights to photos taken in connection with BAPS Motor Speedway events and consents to the publication or sale of such photos by BAPS Motor Speedway. Any dispute, controversy or claim involving the undersigned member, whether or not relating to this agreement or alleged breach of the same, shall be settled in accordance with the existing and/or amended rules and regulations of BAPS Motor Speedway, and the undersigned agrees to accept decisions by such process.