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2026 Cullman Derby Day RACER

Use this form to sign up as a racer at the Cullman Derby Days race! If the racer is under 18, this form must be completed together with a parent or legal guardian.

Race Day is Sunday, July 12th. SIGN UP DEADLINE is July 1st. You will NOT be able register on race day.

Fill out this application form to register for the Derby Day. We have decided to waive registration fees this year because of a generous donation.

Entrants under 18 must be accompanied by a responsible adult. It is incumbent upon the racers to have read and abide by all race and vehicle requirements.

Racers will be sent a waiver prior to the race. This must be signed an returned to check in.

Please make sure you are familiar with Vehicle Requirements.

Team Information

Racer Full Name*

Car Name and/or Building Organization

If under 18- name of parent

... or guardian. Will count as signature.

Age on July 12th 2026*

Note: Entrant MUST be at least 8 years or older on race day

Address

Street,Town/Village, Zipcode

Contact Phone Number

Contact Email*

Receive a confirmation via email

Emergency Contact Name and Number

Your Thursday Color*

Please review what you entered before you click the Submit button, and click it ONLY ONCE.