***Please fill out the form in its entirety. If you fail to meet the requirements, you will not be awarded any monetary payout. Please read the Terms & Conditions prior to filling out the form.***


E-Mail address:

Mailing address:

Event name:

Event date:

What place did you finish?

What is the payout for this finish?


What tires did you use in this race?

What are your social media handles (Facebook, Instagram, Twitter etc.)?

Please upload your pictures (in dwg, pdf, jpg or png format):

Pictures required: 1.) winner on podium. 2.) Picture showing that you have met the helmet and logo requirements. 3.) Picture of OTR tires on the vehicle.