2018 Off-Road Contingency Registration Form

THIS FORM MUST BE COMPLETED IN FULL TO RECEIVE CONTINGENCY!

* = Required field.

This agreement is made this 11/15/2018, 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:

Social Security Number:

bLU cRU Rewards Program Debit Card Parental/Guardian Consent Form

In consideration of Minor's participation in the bLU cRU Rewards Program, I give permission for Minor to receive the bLU cRU Rewards Program Debit Card, and agree on behalf of Minor, myself and my spouse, heirs, Minor's heir's and legal representatives to the terms and conditions of the bLU cRU Rewards Program and the terms and conditions of the bLU cRU Rewards Program Debit Card.

I hereby certify that I am the parent/legal guardian of (DOB: ) and have authority to execute this consent.

Read and Agree

Parent/Guardian First Name:

Parent/Guardian Last Name:

Telephone (Home):

Telephone (Mobile):

I want to receive text alerts from Yamaha on my mobile phone.

Yes No

Email Address:

I would like to receive information by email about Yamaha products. My information will not be sold, nor distributed to anyone outside the Yamaha network. Only U.S. residents will receive messages containing retail promotions. By selecting Yes, I verify I am 18 years of age or older.

Yes No

Social Media

Facebook Web Address:

Twitter Handle:

YouTube Channel:

Instagram Channel:

List series and classes in which you plan to compete (80 characters max.):

List the 2017* or newer model YZ/WR motorcycle(s) you'll be racing by entering frame Vehicle Identification Numbers (VIN - 17 digits).

VIN 1

Model

VIN 2

Model

VIN 3

Model

VIN 4

Model

In the event the warranty registered owner will not be competing, but is sponsoring a rider, please complete the following:

Warranty Registered Owner's Name

First Name:

Middle Initial:

Last Name:

Telephone:

Relationship to Rider:

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 must submit a 2018 Contingency registration form by November 30, 2018, to be eligible for contingency earned in 2018.
Upon 2018 registration approval, NEW bLU cRU members will receive a reloadable Yamaha bLU cRU debit card within 4 to 6 weeks.
All winning riders will be issued credit to their reloadable Yamaha bLU cRU debit card after Yamaha receives confirmation of results from the promoter and rider has completed a registration form and valid I.R.S. Form W-9.
Contingency will be paid to the WARRANTY REGISTERED owner. If warranty registered owner will not be competing, but sponsoring a rider, contingency will be paid to the rider.
Only 2017 or newer YZ, WR, and FX models purchased in the United States will be eligible.
Winning riders must have a valid U.S. social security number to be eligible.
Race results must be received from race promoter within 30 days of event in order for contingency to be paid.
Yamaha will not pay an event when the promoter fails to submit results within 30 days of the event.

In cases of multiple divisions of the same class, Yamaha will pay one division as specified by promoter.
In cases of dual sanctioned events, rider will be paid for one event only.
Contingency will be paid on rider's best finish in one class only, per registered machine.
There will be no multiple class payouts at the same event for the same machine.
There must be a minimum of FIVE riders in a class to qualify for contingency.
The "Yamaha" logo must be displayed on the left and right side of all motorcycles and the "bLU cRU" logo must be displayed on the front number plate of all machines to be eligible.
The original color plastic components must remain on all machines to be eligible.
Go to www.yamahabLUcRU.com for more details.
Program details subject to change without notice at Yamaha's sole discretion.

I have read, understand, and agree to the contingency program terms as listed.

AGREE

* = 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

2018 Off-Road Contingency Registration Form

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