ATTENTION PARENTS OF MINORS

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 of guardian CLEARLY)

child __________________________________ to compete in or be a spectator at a

(Print rider’s full name CLEARLY)

motorcycle event on __________________ at ______________________________. I

(Date) (Event Site)

hereby 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 ____________________________________________