Orange Crate Derby — Washington Celebrates America

Let’s Race.

Please read all safety and rules information before filling out form.

Name/ Nickname of Driver

First Name

Last Name

Age

Name of Parent/Sponsor

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Car Number:

Note: Car numbers will be awarded on a "first come, first serve" basis.

Waiver:

By entering the Orange Cart Derby, I herby agree to hold blameless and do RELEASE the Washington Celebrates America Committee, its agents and officers and volunteers, as well as the Borough of Washington, of any liability for any injuries, loss damage which either I or my family may sustain in route during or returning from the 2024 Orange Crate Derby.