2024 Membership Application

Driver Information:

Parent Information:
If the address is the same, you may leave one blank. Club information is usually sent by e-mail so if you both would

like to receive the information please list both.

All forms of motorsports racing involve risk and the possibility of serious injury or death. It is the responsibility of the parents and family to evaluate these risks and determine at all times whether the VSQMA track facility or events are suitable for use or participation. It is the responsibility of the entire membership of VSQMA to maintain and operate the facility both individually, collectively and through an elected volunteer Board of Directors. Both parents of minor children must sign this application as well as the supplemental form titled, "Parental Consent, Release and Waiver of Liability, Assumption of Risk, Covenant not to Sue and Indemnity Agreement, "Prior to submitting the membership application.

I have Read the above paragraph and agree to be bound by it's terms.


(Printed Name)