Both of the below forms are needed to allow you to drive.

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Open Track

LOS ANGELES SHELBY AMERICAN AUTOMOBILE CLUB

"STREETS OF WILLOW"

TECH FORM - September 25-26th, 2004

Name_____________________________ Phone(day)_____________(eve)_____________

Address___________________________ City_______________ State_______ Zip______

2nd Driver(if any)____________________ Club Affiliation___________________________

Previous track experience: Yes___ No____ At what track____________________________

Car: Year______ Make_______ Model_______ Color_______ Tires: Race____ Street____

ENTRY FEE: (Same group only) DRIVER#1 DRIVER#2 TOTAL

Two day Open Track $150.00 + $25.00 $ ______LATE ENTRY FEE-PAID AFTER September 14, 2004 = $175.00

Shirt size_______ TOTAL AMOUNT ENCLOSED: $______

Make checks payable to: L.A.S.A.A.C. Mail to: c/o Mario Veltri 1719 Spumante, Pleasanton, Ca. 94566

 

TECHNICAL INSPECTION CHECKLIST

**ENGINE** **WHEELS/TIRES** **BODY**

[ ]No gas/oil leaks [ ] Sufficient tread [ ]Brake lights [ ]Cooling system fluids (water only)

[ ]Gas/oil lines tight [ ] No cuts/defects [ ]Fender clearance [ ]Clean engine area

[ ]Cart) return springs [ ] All lugs tight [ ]Door/hood secure

[ ]Elec. Wiring secure [ ] Hubcaps removed [ ]Windscreen/shield

[ ]Heater hose shut off (Pantera) [ ]Cooling system over-flow behind rear tire (Pantera)

**SUSPENSION** **ADDITIONALS** **INTERIOR**

[ ]Brake lines [ ]Approved helmet [ ]Seats secure [ ]Wheel bearings [ ]Brake pedal travel

[ ]Linkage tight [ ]Goggles/shield (Open cars) 

[ ]Roll bar/cage (where req.) [ ]Shocks functional [ ]No steering play [ ]No loose items 

[ ]No leaks (brakes/shocks, etc.) [ ]Safety belts [ ]Brake pads/lining [ ]Fire extinguisher

Second Driver: [ ]YES [ ]NO Other Driver: Car#______________ Class________________

TECHNICAL INSPECTION [ ]PASSED [ ]FAILED

Inspected by:______________________________________________ Date:_______________

Remarks:_______________________________________________________________________

RUN GROUP: [ ]RED-Novice [ ]WHITE- Previous Track-Exp. [ ]BLUE-Competition

RETURN THIS PAGE WITH PAYMENT  

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