2012 DESTRUCTION DERBY

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1 AMADOR COUNTY FAIR and The JACKSON ROTARY CLUB 2012 DESTRUCTION DERBY July 29, 7:00 p.m. Check out the website for Pre-Sale & Assigned Seating Amador County Fairgrounds P.O. Box 9 Plymouth, CA (209) or HaveFun@amadorcountyfair.com or Vehicle Questions: Jimmy Wilson (209) All Non-Vehicle Questions: Erik Christeson (209) Jackson Rotary Club MAIN EVENT PRIZES: 1ST $ & Trophy 2ND $ & Trophy 3RD $ & Trophy HEAT PRIZES: 1ST $ & Trophy 2ND $ & Trophy 3RD $ & Trophy HARD LUCK PRIZES: 1ST Trophy 2ND Trophy 3RD Trophy PRETTIEST CAR: Trophy Amador County Fair Barn in the USA!! July 26 July 29,

2 AMADOR COUNTY FAIR P.O. BOX 9 PLYMOUTH, CA ROTARY DESTRUCTION DERBY ENTRY FORM Pre-Entry Registration Fees (Due by 7/5/12): Post-Entry Deadline Derby Fees: (7/6/12 6 pm): $ (includes 2 pit passes) $ (if slots are available) Prettiest Car Entry Fee (Required for participate in the Prettiest Car Competition): $20.00 Additional Pit Passes: 3 maximum per entry at $ each DOB > July 29, 1994 Driver s Name: Date of Birth: Phone: ( ) Mailing Address: City: Zip: Address: Years of Experience: Make of Derby Car: Model: Year: Derby Car Number: 1 st Choice: 2 nd Choice: Drivers License (Attach Copy) #: State: Expiration Date: Pit Crew Name: Waiver: ID Copy: WB# Paid: included Pit Crew Name: Waiver: ID Copy: WB# Paid: included Pit Crew Name: Waiver: ID Copy: WB# Paid: $ Pit Crew Name: Waiver: ID Copy: WB# Paid: $ Pit Crew Name: Waiver: ID Copy: WB# Paid: $ Sponsor Name and City: Sponsor Name and City: Sponsor Name and City: NO DERBY VEHICLES WILL BE ALLOWED ON GROUNDS BEFORE 8 AM ON SUNDAY (DERBY DAY) I have read and understand the Vehicle and Derby Rules (Driver initial here) I have read and understand the Fair Rules and Regulations (Driver initial here) I have read and understand the Driver/Pit Crew Rules and regulations (Driver initial here) Fair Office use only: Date Paid: Amt Received: Receipt #: Prettiest Car Fee Paid ($20): Driver s Waiver: ID Copy: WB# Return entry form and fees to: Amador County Fair P.O. Box 9 Plymouth, CA For more information, call (209) or HaveFun@amadorcountyfair.com 2

3 RELEASE AND WAIVER OF LIABILITY AGREEMENT I, ("Participant") acknowledge that I have voluntarily applied to participate in the following activities on the grounds of the 26th District Agricultural Association. (Amador County Fairgrounds) (Jackson Rotary Club) the Fair" Destruction Derby July 29, 2012 I AM AWARE THAT THE ABOVE DESCRIBED ACTIVITIES ARE HAZARDOUS ACTIVITIES, AND I AM VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF THE DANGER INVOLVED, AND AGREE TO ASSUME ANY AND ALL RISKS OF BODILY INJURY, DEATH OR PROPERTY DAMAGE. I VERIFY THIS STATEMENT BY PLACING MY INITIALS HERE: As consideration for being permitted by the Fair and the State of California to participate in these activities and use their facilities, I hereby agree that I, my assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives will not make a claim against, sue, or attach the property of the Fair or the State of California or any of their affiliated organizations as a result of my participation in the activities described above. I forever release the Fair and the State of California and any of their affiliated organizations from any and all action, claims, or demands that I, my assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives now or hereafter have for injury or damage resulting from my participation in the activities described above. I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND THE FAIR, AND THE STATE OF CALIFORNIA AND/OR THEIR AFFILIATED ORGANIZATIONS AND SIGN IT OF MY OWN FREE WILL. I understand I am responsible for the conduct of my pit crew and realize the pit crew may cause me to be disqualified for infractions: Executed at Plymouth, California on, PARTICIPANT Name: Driver or Pit Crew-member (Circle one) Address: City: State: Zip: Phone #: Cell #: address: Signature: Date: I have read and understand the Vehicle and Derby Rules I have read and understand the Fair Rules and Regulations I have read and understand the Driver/Pit Crew Rules & regulations WB #: 3 PAID:

4 RELEASE AND WAIVER OF LIABILITY AGREEMENT I, ("Participant") acknowledge that I have voluntarily applied to participate in the following activities on the grounds of the 26th District Agricultural Association. (Amador County Fairgrounds) (Jackson Rotary Club) the Fair" Destruction Derby July 29, 2012 I AM AWARE THAT THE ABOVE DESCRIBED ACTIVITIES ARE HAZARDOUS ACTIVITIES, AND I AM VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF THE DANGER INVOLVED, AND AGREE TO ASSUME ANY AND ALL RISKS OF BODILY INJURY, DEATH OR PROPERTY DAMAGE. I VERIFY THIS STATEMENT BY PLACING MY INITIALS HERE: As consideration for being permitted by the Fair and the State of California to participate in these activities and use their facilities, I hereby agree that I, my assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives will not make a claim against, sue, or attach the property of the Fair or the State of California or any of their affiliated organizations as a result of my participation in the activities described above. I forever release the Fair and the State of California and any of their affiliated organizations from any and all action, claims, or demands that I, my assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives now or hereafter have for injury or damage resulting from my participation in the activities described above. I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND THE FAIR, AND THE STATE OF CALIFORNIA AND/OR THEIR AFFILIATED ORGANIZATIONS AND SIGN IT OF MY OWN FREE WILL. I understand I am responsible for the conduct of my pit crew and realize the pit crew may cause me to be disqualified for infractions: Executed at Plymouth, California on, PARTICIPANT Name: Driver or Pit Crew-member (Circle one) Address: City: State: Zip: Phone #: Cell #: address: Signature: Date: I have read and understand the Vehicle and Derby Rules I have read and understand the Fair Rules and Regulations I have read and understand the Driver/Pit Crew Rules & regulations WB #: 4 PAID:

5 RELEASE AND WAIVER OF LIABILITY AGREEMENT I, ("Participant") acknowledge that I have voluntarily applied to participate in the following activities on the grounds of the 26th District Agricultural Association. (Amador County Fairgrounds) (Jackson Rotary Club) the Fair" Destruction Derby July 29, 2012 I AM AWARE THAT THE ABOVE DESCRIBED ACTIVITIES ARE HAZARDOUS ACTIVITIES, AND I AM VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF THE DANGER INVOLVED, AND AGREE TO ASSUME ANY AND ALL RISKS OF BODILY INJURY, DEATH OR PROPERTY DAMAGE. I VERIFY THIS STATEMENT BY PLACING MY INITIALS HERE: As consideration for being permitted by the Fair and the State of California to participate in these activities and use their facilities, I hereby agree that I, my assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives will not make a claim against, sue, or attach the property of the Fair or the State of California or any of their affiliated organizations as a result of my participation in the activities described above. I forever release the Fair and the State of California and any of their affiliated organizations from any and all action, claims, or demands that I, my assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives now or hereafter have for injury or damage resulting from my participation in the activities described above. I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND THE FAIR, AND THE STATE OF CALIFORNIA AND/OR THEIR AFFILIATED ORGANIZATIONS AND SIGN IT OF MY OWN FREE WILL. I understand I am responsible for the conduct of my pit crew and realize the pit crew may cause me to be disqualified for infractions: Executed at Plymouth, California on, PARTICIPANT Name: Driver or Pit Crew-member (Circle one) Address: City: State: Zip: Phone #: Cell #: address: Signature: Date: I have read and understand the Vehicle and Derby Rules I have read and understand the Fair Rules and Regulations I have read and understand the Driver/Pit Crew Rules & regulations WB #: 5 PAID:

6 ROTARY DESTRUCTION DERBY Sunday, July 29, :00 P.M. VEHICLE & DERBY RULES 1. Officials reserve the right to disqualify any entry for any rule violation. 2. Protests must be filed, in writing, within 24 hours of the event. Protests must be accompanied by a deposit of either $ (cash, money order or certified check made payable to the Fair). 3. Previous derby cars not meeting the following requirements will not be allowed. 4. No Imperials, commercial vehicles, pickup trucks, SUV s or 4 wheel drives will be allowed to participate. 5. No packing (e.g. concrete) of frame allowed. No reinforcement of frame allowed. Officials may cut and drill frames prior to Derby at the time of inspections. No welding of body seams. No additional bolts/fasteners allowed on body/sheet metal. 6. All glass, hardware, chrome strips and front grilles must be removed from the car before entering the fairgrounds. 7. Doors must be chained or welded shut securely. Gaps in doors may be filled. Full weld is acceptable. No external metal straps. One (1) bolt through the door to the safety cage is acceptable. 8. All chains on vehicle must be at least a minimum 1/4" chain or maximum 1/2" chain. No chains to exceed three feet (3') in length anywhere on vehicle. 9. Trunk lids may be welded, chained or bolted; no combinations. Station wagon s rear door is considered a trunk lid and must be in the fully closed position. Maximum bolt one inch (1") in diameter - maximum washer three inches (3") in diameter, all washers no more than 1/4" thick. Only two (2) bolts allowed on trunk. Bolts will not be welded. There shall be a 12 hole in the trunk lid to allow inspection. If trunk is to be welded, it will be welded for 2, skip 6, welded 2 around the entire lid. Maximum of two (2) chains may pass around rear bumper to hold it in place. 10. Hoods are to be secured in all four (4) corners. Hoods may be bolted with a maximum of four (4) 1" bolts, all washers maximum of 1/4". No J-bolts, bolts, chains, etc., from frame to hood. Hood must have a minimum ten inch (10 ) hole over carburetor for safety. Maximum of two (2) chains may pass around front bumper to hold it in place. 11. Bumpers must be OEM (original equipment manufacturer). Stock brackets may be welded to bumper and frame. No braces welded or added to bumper. Bumper cannot be welded to body. Bumper tips and fender wells can be trimmed. No reinforcing... Official's decision is final. 12. Seat belts must be securely fastened and worn at all times. 13. Batteries must be securely bolted or chained in place (plumber's tape is not considered adequate as a securing device). 14. The battery should be located, as it always has, in the front passenger s compartment and shall be securely covered by a flame-resistant material in order to stop any acid splash or any sparks connecting with the gas - which is also kept in the passenger compartment. 15. Stock gas tanks must be removed. 16. No starting fluid in car. 17. The temporary gas tank must be placed forward of the rear axle and may contain a maximum of six (6) gallons of gas. Temporary gas tank must be metal or fuel cells may be used. (No plastic allowed) 18. ONLY factory fuel injected cars may use electric fuel pump. Fuel pump must be located within 16 of the fuel tank. A fuel pump Shut Off switch must be mounted on the outside roof of the car directly over the driver. This will be tested during inspection. A 10 diameter circle must be painted around the switch, using contrasting bright color. 19. Radiator must be stock automobile and in original stock position. No additional radiator supports or mounts. Firewall must be stock with no large holes. No radiator water inside of car. 20. Transmission coolers must be securely fastened to floorboard and behind driver compartment. All hoses, tubing, etc. shall exit the vehicle through the floorboard. All interior cooler lines must be wrapped with duct tape or inner tube. 6

7 VEHICLE & DERBY RULES continued 21. No reinforcing will be allowed except on the driver's door. No frame reinforcements allowed. 22. No tire chains, spikes, studs or dual tires will be allowed. 23. Body-to-frame hardware and bushings must be OEM stock. Frames must be in OEM condition on any/all vehicles. 24. Car number must be placed on the top (not hood or trunk) and both doors of the car. All car numbers and letters must be at least eighteen inches (18 ) high and one and one half (1 ½ ) wide. 25. Driver's safety cage - a rectangle from driver's door to passenger door in front of and behind driver attaching to each door may be constructed to create a driver's safety cage. Two (2) cross bars may be welded to connect the cage in front of and behind the driver - one (1) cross bar located to the left of the driver and one (1) cross bar located to the right of the driver. The right cross bar must be located no more than 12 from the passenger door to the right of the driver. Two (2) diagonal bars from back cross bar to floor pan extending no more than 12 behind drivers seat and no more than 20 from center of car will be allowed. 26. Side impact support bar shall be one (1) piece extending from passenger side door to driver's side door with a maximum six inch by six inch by one quarter (6" x 6" x 1/4") support plate. 27. Station Wagons The hinged or loose rear seat and/or spare tire cover must be removed completely. 28. Overflow hose must be installed over transmission filler tube and must extend down below bottom of frame. 29. Front and rear bumper height will be measured between 20 and 22. Measured from the ground to bottom of bumper. No solid suspensions are allowed. Suspension must give when pressure is applied. No leaf spring to coil spring or coil spring to leaf spring conversions allowed. 30. In most vehicles there are a series of knock-out plugs in the floorboards. These shall be removed so that any gas spilled in the passenger compartment will drain out through the floor of the car. If there are not any knock-outs in the floor, a minimum of six (6) holes shall be drilled in the area of the gas tank. 31. Three (3) # 4 rebar or equal to must be used, vertically from center of the windshield to the left in front of the driver. Mesh screen covering windshield opening may be used as protection of the driver against flying objects. Back window area to be free and open. (No reinforcing or blocking allowed). 32. Each car must have a minimum of front brakes - in good working order. This will be checked and enforced during inspection. Cars not meeting requirement will be disqualified. 33. Obvious teaming-up between two (2) or more cars is grounds for immediate disqualification of vehicles involved. This will be a judgment call from the judges in the arena and in the tower. JUDGES DECISION WILL BE FINAL. 34. When there are three or less vehicles still actively participating in an Elimination Heat or Hard Luck Heat, the Judges reserve the right to end the Heat and to assign appropriate rankings to the remaining active vehicles for the purpose of preserving these vehicles for participation in the Final Round. 35. In the event of an emergency or any situation requiring the stopping of action in the arena, a horn will sound at which time all cars must come to a complete stop! No driver is to leave the car or unfasten the seat belt until the heat is finished except in the case of fire. Failure to comply with this rule will result in immediate disqualification from the event and from participation in derby events for one (1) year. 36. THREE FIRES IN ONE HEAT means DISQUALIFICATION for that heat. 37. After an official time-out, all cars not previously disqualified will have two (2) minutes to get started and make contact with another vehicle under its own power. 38. Any car not contacting another car, under its own power after a two (2) minute period, will be disqualified. 39. Any driver intentionally contacting another car's driver's door will be disqualified. Cars disqualified for infractions of this rule shall be disqualified for the remainder of this derby. 40. All cars left unattended will be at the driver's risk. 41. Any derby official has final decision on any and all questions and disputes. All decisions of the officials will be final. 7

8 VEHICLE & DERBY RULES continued 42. Any spillage of fuel, oil, coolant or other liquids must be cleaned up immediately. All trash / vehicle parts must be removed by participants. 43. Pit speed is 5 MPH or slower at ALL times. 44. Communication equipment (IE: headsets, etc.) will not be allowed for driver or pit crew, at any time. 45. Vehicles may be REINSPECTED at ANYTIME! Failure to pass re-inspection will result in immediate disqualification. 46. I understand, I am responsible for the removal of all cars from the Fair property within two (2) hours of completion of the Derby and that any costs incurred for towing and removal of the car to my address of residence or storage facility will be paid by me. An additional charge of $100 per vehicle will be charged for other costs over and above towing and removal costs. 47. All entry fees, Pre and/or Post are non-refundable. 48. No Service trucks/vehicles over 1 ton in size and No lifts/booms will be allowed in the pits. NOTE: Your car should be Derby Ready BEFORE derby day! The day of the Derby is NOT the time to build your car! ROTARY DESTRUCTION DERBY Sunday, July 29, 7:00 P.M. FAIR RULES AND REGULATIONS 1. Entry fee for each driver is $ (including two (2) pit crew) Pre-Registration. All entry blanks must be filled in completely and be accompanied with the entry fee. Three (3) additional Pit passes may be purchased for $20.00 each, from the Fair s Office, if space and safety allows. Make checks payable to the Amador County, and mail to P.O. Box 9, Plymouth, CA Releases of Liability must be signed. ALL ENTRY FEES (Pre & Post) AND PIT PASSES MUST BE PURCHASED AT THE FAIR S OFFICE. 2. All Pre-entries must be in by 5 p.m. on Thursday, July 5, All Entries received after this date (Post entries) including Derby day will be $ IF SLOTS ARE AVAILABLE. All entries are final and no refunds will be given. 3. Entries are limited to the first thirty-six (36) paid entries in the Destruction Derby and will be held to that amount. 4. Drivers must be eighteen (18) years of age or older, have a valid driver s license and sign the application stating such. Don t forget to attach a copy of the driver s license to the application! 5. There will be no more than three (3) elimination heats and one Hard Luck heat. 6. The main event will consist of five (5) top vehicles from the elimination heats. Sixth (6th) place heat qualifiers will be on standby in the event that any qualified car is unable to participate. All remaining cars not qualified in the elimination heats will go to the Hard Luck round. The top three (3) cars in the Hard Luck round will qualify for the main event. 7. When there are three or less vehicles still actively participating in an Elimination Heat or Hard Luck Heat, the Judges reserve the right to end the Heat and to assign appropriate rankings to the remaining active vehicles for the purpose of preserving these vehicles for participation in the Final Round. 8. ***New***The finals will be held twenty five (25) minutes after the last car has been removed from the arena following the Hard Luck round. 8

9 9. Heat positions/car selections will be done by random draw on the day of the derby at approximately 6 p.m. 10. Prize money and trophies will be awarded to First (1 st ) through third (3 rd ) place in each heat. Trophies will be awarded for First (1 st ) through Third (3 rd ) place in the Hard Luck round. Prize money and trophies will be awarded to First (1 st ) through Third (3 rd ) place in the Main Event. 11. Prettiest Car: Drivers wishing to participate in the Prettiest Car Competition must check the box on the application and pay an additional $20.00 Fee. A trophy will be awarded for prettiest car and will be decided by applause/response of the attending spectators as determined by the judges. 12. All money and trophies will be awarded at the end of each heat, hard luck round, and after the Main Event. 13. Amador County Fairgrounds is public property. "Driving under the influence" arrests can and will be made if persons are operating any vehicle under the influence of alcohol or non-prescription drugs. 14. There will be three pit passes given for each entry. One for the driver and two for pit crew-members; a maximum of 3 additional pit-crew passes per entry may be purchased at the Fair Office for $ 20 each. 15. Pit Passes entitle the bearer to sit in the Calf Pens ONLY, not the Grandstands. 16. Pit Crew Members sitting on the fences of the Calf Pens will be ejected and the Pit Pass revoked. A second violation from the same team will result in the DISQUALIFICATION of the associated Driver and Car. 17. NO ONE is permitted in the entry gate area ONCE THE GATES HAVE CLOSED. Pit Crew Members violating this rule will be ejected and the Pit Pass revoked. A second violation from the same team will result in the DISQUALIFICATION of the associated Driver and Car. 18. No vehicle except the entry car and one support vehicle will be allowed in the pit area. No trailer parking in inspection area UNTIL AFTER 4:00 pm. absolutely no exceptions! 19. NO DERBY VEHICLES WILL BE ALLOWED ON GROUNDS BEFORE 8 AM, SUNDAY, DERBY DAY. Violators will be subject to disqualification and escorted off grounds by security, forfeiting entry monies. FAIR RULES & REGULATIONS CONTINUED: 20. WRISTBANDS WILL NOT BE GIVEN OUT UNTIL I.D., RELEASE FORM, AND, IF APPLICABLE, PAYMENT IS RECEIVED FOR THAT INDIVIDUAL. NO EXCEPTIONS. 21. NO ADDITIONAL WRISTBANDS WILL BE GIVEN OUT BEYOND THE 6 THAT ARE ALLOWED WITH THE ENTRY (1 DRIVER & 5 PIT CREW MEMBERS). IF WRISTBANDS ARE LOST, NONE WILL BE DISTRIBUTED TO REPLACE THEM. 22. **NEW** Derby paperwork will be accepted in the Fair s Administration office, at the front of the fairgrounds, until 6 pm Saturday, July 28, A. ON SUNDAY, JULY 29, 2012, DERBY PAPERWORK WILL BE ACCEPTED IN THE HORSE SHOW OFFICE (THE OFFICE NEXT TO THE ARENA ENTRANCE) BETWEEN 11 AM 5 PM. B. AFTER THIS TIME FRAME, ADMITTANCE FOR DRIVERS AND PIT CREW WILL BE CLOSED. 23. CLOSE TOED SHOES MUST BE WORN AT ALL TIMES BY ALL DRIVERS AND PIT CREW MEMBERS (NO SANDALS, ETC. ALLOWED). 9

10 ROTARY DESTRUCTION DERBY SUNDAY, July 29, :00 P.M. DRIVER/PIT CREW RULES AND REGULATIONS 1. There will be no alcoholic beverages or use of non-prescription drugs allowed in the pits or the immediate surrounding area. Drivers and pit crew-members shall NOT drink before or during the event. No O Douls or other non-alcoholic brews will be allowed in the pits. 2. Violation of any of the rules or lack of cooperation with fair or derby officials by any driver or pit crew-member will result in immediate disqualification, forfeiture of entry fees of the subject entry and disqualification from derby events for one (1) year. 3. Vehicle inspection will begin at 11:00 a.m. on the day of the event in the staging area. Inspection will end at 4:00 p.m. Vehicles will be allowed in pit area as-soon-as pit area has been cleared and prepared. A mandatory Drivers Safety Meeting will be held at approximately 6:00 p.m. ALL DRIVERS MUST ATTEND. 4. Only those possessing a valid gate pass worn around the wrist (wristband) will be allowed in the pit area. This includes one (1) driver and up to a maximum of five (5) crew-members per entry. Pit passes can be purchased for $20.00 each, from the Fair s Office, if space and safety allows. No vehicle except the entry car and one support vehicle will be allowed in the pit area. No trailer parking in inspection area UNTIL AFTER 4:00 pm. absolutely no exceptions! ALL ENTRY FEES (Pre & Post) AND PIT PASSES MUST BE PURCHASED AT THE FAIR S OFFICEs. 5. Only car, driver, pit crew-members and support vehicle properly identified will be permitted to enter the pit area. No one under 18 years of age will be allowed in the pit area due to fair grounds liability. 6. No pit crew-members allowed in arena during or after each heat unless approved by gate official. 7. No service trucks or vehicles over 1 ton in size will be allowed in the pit area UNLESS servicing MORE than one vehicle and then one team MUST forego their service vehicle. 8. No lifts or booms will be allowed in the pit area. 9. All wording on the vehicles and team shirts, if applicable, will be in good taste. 10. Drivers must provide proof of age. All drivers must be present at car during inspection and will produce their helmet at that time. Driver's licenses will be checked by clerical staff when wristbands are issued. 11. All cars scheduled for each event must enter the arena when the event is called. A maximum of two minutes will be allowed between each car entering the arena. 12. No driver or car substitutions will be permitted after vehicle inspection. Car and driver are a "Team" throughout the derby. 13. No vehicles except those designated as tow vehicles; will be allowed in the arena between events. 14. A full-face helmet is mandatory and must be strapped on during the derby. Drivers should refrain from wearing clothing made of synthetic material (i.e. nylon, rayon, etc.) Drivers should wear long-sleeve shirts during the derby. Eye protection is RECOMMENDED. 10

11 Amador County Fair Jackson Rotary Destruction Derby Attention: All drivers must turn in completed driver / inspector check list on derby day at time of check in. The inspectors will use this form to check / inspect your car. Safety Items: Driver Inspector Vehicle Compliance: Driver Inspector Drivers Signature: 1. Full face helmet. 2. Seat / Lap belts. 3. Rebar / Driver side windshield. 4. Battery secured and covered. 5. Fuel tank / Fuel Cell secured. 6. Stock Gas tank removed. 7. Hole in hood above carb. 8. Hood secured in all four corners. 9. Drivers safety cage. 10. Electric fuel pump shut off switch (if applicable). 11. Transmission overflow tube. 12. Drain holes in floor pan around fuel tank. 13. Doors securely fastened. 14. Front brakes in working order. 1. Bumper height (20 to 22 ) front and rear. 2. Factory bumpers. 3. Frame check. 4. Tire check. 5. Suspension check. 6. All glass, hardware, chrome, etc. removed. 7. Stock radiator. 8. Transmission cooler and lines secure & behind driver 9. Body seams NOT welded. 10. Car numbers clearly marked. 11. Inspect inside trunk. Bring your car Derby Ready!!! Inspectors Signature: Date: Time: 11

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