Date:_____________________

To Whom It May Concern:

My child, _______________, who is _____ years old, has my permission to attend a Cycle City Promotions Arenacross event without me present.  I am sending my child with _________________ who has my persmission to register my child to race and compete in said motorcycle race.

I understand that this type of activity can be dangerous and that there is a possibility of injury and/or death.  I have read and signed the minor release form provided, and required, by Cycle City Promotions.  I agree to all of the terms of the minor release form.

I have attached a copy of my drivers license and of our health insurance card in the event my child needs medical care before, during or after this motorcyle race.

I can be contacted at the following numbers during the hours of this race:

______________ cell

______________home

______________alternate

___________________________

parent signature

____________________________

2nd parent signature