Road Race Contingency Registration Form

THIS FORM MUST BE COMPLETED IN FULL TO RECEIVE CONTINGENCY!
SUBMIT ONLY ONE FORM FOR THE ENTIRE 2013 SEASON!

* = Required field.

This agreement is made this 6/19/2013, by and between Yamaha Motor Corporation, U.S.A. and:
Rider's Name*
* First Name:  
Middle Initial:
 * Last Name:  
Rider's Legal Name (if different)*
First Name:
 Middle Initial:
 Last Name:
* Address:  
* City:  
 
* State or Province    
* Zip Code:  
* Date of Birth:
Click here to choose a date 		* Social Security Number:        
- -
Email Address:
* Telephone:            
( ) - 		 
List the 2011 or newer model motorcycle(s) you'll be racing by entering frame Vehicle Identification Numbers (VIN - 17 digits) below beginning with "JYA."
*   Model [ ]
  Model [ ]
  Model [ ]
* Team Name:  
Rider agrees that Yamaha shall have a license to use rider’s name, signature, initials, likeness, photograph and similar materials in connection with the advertisement, promotion and sale of products distributed by Yamaha and any subsidiary of Yamaha.
  • Riders who have not turned in a 2013 Contingency and W-9 Form by October 31, 2013, will not be eligible for contingency earned in 2013.
  • Only 2012 and newer U.S. model YZF-R6 and YZF-R1s purchased in the United States are eligible.
  • Race reults must be received from promoter within 30 days of event in order for contingency to be paid. Yamaha will not pay an event when the promoter fails to send in race results within 30 days of the race date.
  • YZF-R6s will be eligible for contingency in 600cc classes only, not in Open classes.
  • All winners will be paid by check after Yamaha receives confirmation of results by the promoter and rider has completed a registration form and valid I.R.S Form W-9.
  • The correct "Tuning Fork YAMAHA" logo must be prominently displayed on all machines to be eligible. Logos are available from event promoters.
  • YZF-R1s and YZF-R6s must maintain standard bodywork appearance to be eligible.
  • There must be a minimum of 7 riders in a class to be eligible for contingency.
  • Promoter must confirm, within 30 days of event, that rider met qualifications before contingency will be paid.
  • Must have a valid U.S. social security number to be eligible.
  • Program details are subject to change without notice at Yamaha Motor Corporation's discretion.
  • After submitting an online registration, if you wish to make any changes to your information, fax to: 714.229.7974 or email to: racingcontingency@yamaha-motor.com
You have read, understand, and agree to the contingency program terms as listed. *
* = Required field.
Yamaha Motor Corporation, U.S.A. 6555 Katella Avenue, Cypress, CA 90630 Attn: Contingency
Phone: 714-761-7509 Fax: 714-229-7974 Email: racingcontingency@yamaha-motor.com