Application Form

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CAR NUMBER

Local Director's Use Only
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Local Race City Organization
Select Division you are participating in:*
Profile Picture*
Accepted file types: jpg, Max. file size: 50 MB.
Please upload the Participant mug photo and must be on JPG file format
Participant's Name*
First Last
Phone:*
Mailing Address:
Street Address Address Line 2 City State ZIP Code
School:*
Grade:*
Age:*
Date of Birth:*
MM slash DD slash YYYY

(You must send a copy of birth certificate)
Parent/Guardian Email:*
Is your car sponsored?*
Sponsored by:*
Racer of a Soap Box Derby car entered in the official Soap Box Derby Local Race being held in, hereby certify that my car has been built in full compliance with the most current construction plans and rules published by the International Soap Box Derby, Inc.*
I agree to the privacy policy.
Racer of a Soap Box Derby car entered in the official Soap Box Derby Local Race being held in, hereby certify that my car has been built in full compliance with the most current construction plans and rules published by the International Soap Box Derby, Inc.
Photograph Terms*
Yes, I do accept the terms
By checking this box below, I am aware photographs and videos will be taken and used for marketing including the use of social media for this program. I have proper authorization for each student attending to be photographed or videoed. If you have questions, please email us at soapboxderby@letsgrowsteam.org or call 706.577.3409
Parent/Guardian's Info
Parent/Guardian's Name:*
First Last
Relationship to Participant:*
Mailing Address:*
Street Address Address Line 2 City State ZIP Code
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I agree as (parent/guardian), hereby certify that my son/daughter/ward, entrant in the official Soap Box Derby Local Race being held in Columbus, Georgia, has read the above statement completed by my son/daughter/ward and know the facts stated therein to be true. Further, I hereby grant permission for my son/daughter/ward to enter the official Soap Box Derby Local Race in Columbus, Georgia, and in the event he or she is adjudged the winner of the official Soap Box Derby Local Race, to participate in the FirstEnergy All-American Soap Box Derby World Championship in the current race year in Akron, Ohio. Further, I understand and agree that, as a prerequisite to competing in the FirstEnergy All-American Soap Box Derby in Akron, Ohio, that my son/daughter/ward, together with his/her car, shall have undergone and passed an inspection conducted in Akron, Ohio by the International Soap Box Derby, Inc. I further understand and agree that such inspection shall be conducted using the manner and methods deemed appropriate by the International Soap Box Derby, Inc., in its sole discretion, to determine compliance with its rules, spirit and specifications applicable to that division and that the decisions of the International Soap Box Derby, Inc. and its officials regarding qualification, disqualification and compliance with the rules, spirit and specification applicable to that division shall be final and binding upon me, my son/daughter/ward and all other parties. Finally, I, as such parent or guardian, in consideration of the benefits received as a result of the participation herein, and for the mutual benefits received by myself and my child and the other participants herein, hereby waive and release any and all claims, rights, causes of action, demands or otherwise, whether for personal injuries, property damage, or any other loss, damages or expenses which I, as a parent/guardian, and/or my son/daughter/ward may have against the Local Soap Box Derby, its sponsor, the International Soap Box Derby, Inc., and/or its sponsors, agents, employees, full or part-time, or associates of any status whatsoever, arising from or in any manner related to my son's, daughter's or ward's participation in the Local Soap Box Derby, the FirstEnergy All-American Soap Box Derby and/or any activities incidental or related thereto.
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I Robbie D. Branscomb the Local Race Director of the official Soap Box Derby Local Race being conducted by River City Soap Box Derby (sponsor), have read the statement about, signed by the entrant and his or her parent/guardian, and understand the facts therein to be true. I have inspected his/her car and, in my opinion, it meets all construction requirements for the Stock, Super Stock, or Masters division.
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Parent/Guardian Signature
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Date
Race fee:*
Tshirt Quantity:*
Tshirt Size 01:*
Tshirt Size 02:*
Tshirt Size 02:*
Tshirt Size 02:*
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Tshirt Size 03:*
Tshirt Size 03:*
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Tshirt Size 04:*
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Tshirt Size 05:*
Tshirt Size 05:*
Tshirt Size 06:*
Total
$0.00
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Application Form

Parent/Guardian's Info

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