2018 Cornerspeed Registration Form
First Name: Last Name:
Address:
City: State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VI VA WA WV WI WY Zip Code:
Phone: Email for Confirmation: *Required
Yes! I am Active Military - I will forward a copy of my military ID via fax or email for my $25.00 discount. Fax (704) 332-3140 or email admin@cornerspeed.net.
Where did you hear about us? Please select... Search Engine (enter which search engine to the right) Friend (enter friend's name to the right) Repeat Customer Website (enter website name to the right) Magazine (enter Magazine to the right) Online Forum (enter forum name to the right) Article Review (enter Article name to the right)
Please choose your registration event date:
Choose your Registration Type below:
Please select your payment method: I will mail a check or money order made payable to: Cornerspeed, 707 Jackson Ave. Charlotte, NC 28204 Payment must be received within 10 business days from the date you submit this form to secure your spot. I will pay by PayPal (debit, credit or bank draft). (You will receive an invoice directly from PayPal.) Please charge my credit card - I understand there is a $10.00 Convenience Fee added to the registration fee.
For Credit Card payments: Credit Card Type: VISA Mastercard Discover Credit Card Number: Exp. Date: 3-digit Code from back of card: Billing Address (if different from above):
Comments or Questions: (Enter any credit and/or gift certificate information here)
Cancellation, Refund & Credit Policy: No refunds - credits only. We ride rain or shine. 30-days notice of cancellation = 100% credit. Less than 14-days notice of cancellation = 50% credit. Less than 7-days notice of cancellation or no-shows forfit full amount = 0% credit. Credit dates are at our discretion. Events co-sponsored by another party are not eligible for credits.
Please note: If you wish to use an electricity box at VIR, they will collect a $25.00 fee. They have not done this in the past at our events, but have started to enforce the fee.
By checking this box, I verify that I have read and understand the cancellation, refund & credit policy.
You will receive an email confirmation within 2 business days after submitting this form. Thank you for choosing Cornerspeed®!
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