Motor Racing Questionnaire
Motor Racing Questionnaire Name (first, middle initial, last) Date of birth (d/m/y) Policy no. ________________ - __ Advisor’s name Advisor’s no. 1 | Automobile racing Types(s) of racing engaged in: Auto crash: २ T-bone, Rollover, Dive Bomber, etc. Kart २ Enduro, Sprint २ Demolition Derby २ Experimental, others २ Grand Touring (including Trans-Am Midget/Sprint car: २ 1/4, 1/2 and IROC) २ 3/4 Full (Outlaw) २ Record attempts २ IMSA GT Drag Racer: २ Top Fuel Dragster, Funny Car, Prostock (PRO) २ Indy Light Car २ Other or Amateur २ Vintage or other sports car racing २ Off-Road (Baja 500, Mexican 1000, etc.) Rally: २ Professional २ Stock car (Specify type) २ Other or amateur Record Attempts २ Sedan Racing (BMW, Audi, etc.) Jet Car: २ Exhibition २ Time trials २ Record attempts २ Pleasure or Income Sports Cars: २ Can-Am Professional Training २ Yes No Other _________________ २ Formula car (Specify type): Make(s), model(s) and engine size(s) of vehicles(s): _____________________________________________________________________________ ______________________________________________________________________________________________________________________________2 | Motorcycle racing Types(s) of racing engaged in: २ Drag Racer: २ Top Fuel २ Road racing (Grandprix or Productions): २ Stunt riding, acrobats, daredevils, २ Modified २ Street or stock Engine size: _____________ cc time trials or speed record attempts Make and model: _____________ _____________________________ Professional Training २ Yes २ No २ Pleasure or २ Motorcross: २ Income Engine
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