CCI-contingency form

Full Name *

Social Security Number *

Phone Number *

Address *

Address 2

Email Address *

City *

State *

Zip Code *

Authorized Events (please check you attended)
*Any event not listed must be approved prior to submitting form or else will not be approved for payout.
*Max payout per car, per person, per invoice is $800 per calendar year.
*Form and all items must be submitted within 2 weeks of the event.

*Race field must be 3 or more vehicles to qualify.

Tier 1 Events Attended(please check if you participated at an event listed below)

Tier 2 Events Attended(please check if you participated at an event listed below)

Tier 3 Car Show Events Attended(please check if you participated at an event listed below)

Import Alliance

The Illest

Date Of Event *

Type of Car *

Class Your Car Raced In. Write Class Name Out *

Placement at Event *

Type of Racing *

Link to race results. *

0/500 characters

Eligibility Requirements
*This form completed in its entirety.
*Proof of purchase uploaded through form. Date on invoice must be within 2 years of today's date and must be for a complete clutch assembly-Conventional or Twin/Super Single.
*Photo of your car at the event (upload)

*Photo or pdf of US W-9 Form(upload)
*Competition Clutch Official Contingency Decal must be affixed and on the car in a fully visable manner. These stickers can be obtained from CCI free of charge.

*Race field must be 3 or more vehicles to qualify.

All of the above items must be completed to receive payout. You will not receive payout if any items are incomplete, missing, or not adhered to!

To submit form all required areas must be completely filled out.

Upload your Proof Of Purchase * 🛈

Upload image of your car at event.

Upload W-9 Form

I have read and understand the requirements of the Contingency Program *

Yes

Signature. By typing your name in the signature box, you agree to the terms of CCI Contingency program. *

Due to the high number of events that take place throughout the season, it is the responsibility of the contingency participant to notify Competition Clutch of any applicable earnings. Please contact our marketing department with any questions. Email them to marketing@competitionclutch.com

GRS Drag Events	VORES Racing Series	Import Face-Off
Honda Day	Formula Drift	Chevy Nationals
LS Fest	Global Time Attack	Ford Nationals
NASA Championship Event	Rally America	Pan American Nationals
World Cup Finals	Super Lap Battle	XFWD (Orlando Speed World Events)
Texas 2K	Florida 2K	USTCC Events
Wanna Go Fast

VORES	Street Wars (OGS Event)	Spring Nationals
Pirelli World Challenge	IDRC Shootout	Import Revolution
KMS Drift	Streetwise Drift	SCCA
NASA Regional Racing	Ill Fest	Import Revival
Import vs Domestic (Drag Race Nationals)