MINOR CONSENT FORM

ATTENTION: PARENTS OF UNDER 18
YEAR OLD RACERS OR SPECTATORS

This form (or copies of this form) MUST be used for EVERY Motokazie, Inc.
event that a minor (under the age of 18) competes in, or is simply a spectator at, if you will not
be present.  NO EXCEPTIONS.

THIS FORM MUST ALSO BE NOTARIZED TO BE A VALID DOCUMENT.

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I (we) ____________________________________ do hereby give my permission for my

^{(Print Legal parent or guardian CLEARLY)}

child _____________________________________ to compete in or be a spectator at a

^{(Print rider’s full name CLEARLY)}

motorcycle event on _________________ at __________________________.  I hereby

                                           ^{(Date)                                                            (Event site)}

authorize _________________________ to act in my behalf as a guardian for my child.

Signature of Parent ___________________________________  Date ______________

NOTARY COMPLETE THE FOLLOWING SECTION:

On this ____ day of ________________, 20_____ in the county of _________________,

state of _____________________, the parent / legal guardian _____________________________,

being of legal age, personally appeared before me to be the person

whose name is herein subscribed

NOTARY SIGNATURE _________________________________________

Notary Public, County of _______________________________.