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2015 GOODYEAR TIRE
SCCA U.S. MAJORS TOUR CONTINGENCY PROGRAM
CLAIM FORM
REGISTRATION: Competitors must be officially registered to participate in the program before the date of the event in which you will
be competing. Additionally, competitors must complete and submit this official verified Claim Form no later than 30 days after each
eligible event.
DECALS AND PATCHES: All competitors must display two 12” or larger Goodyear Tire decals – one on each front fender or side pod.
No competing decals or patches may be displayed. Decals are provided by the on-site service dealer or may be requested by sending
your color preference (black or white) to SCCA Member Services at [email protected].
VERIFICATION and AWARD PAYMENT: Decal placements and product use (all four tires must be Goodyear Tires) must be
verified on-site by a tech official - who must sign this claim form. Claim forms may be signed prior to the posting of Official Results.
Completed claim forms must be submitted with a copy of the Official Race Results and will be verified upon receipt. Finishing positions
will be verified by the SCCA National Staff; awards will be made to legal finishers only. Award checks will be mailed by Goodyear Tires
to the address provided approximately 60 days after claim receipt.
NAME: ___________________________________________
EVENT LOCATION: _____________________________
ADDRESS: _______________________________________
EVENT DATE: __________________________________
CITY: _____________________________________________
FINISH POSITION: ______________________________
STATE: __________________ ZIP: ____________________
CLASS: _________________ CAR # _______________
DAY PHONE: ______________________________________
E-MAIL: ___________________________________________
TIRE MODEL: __________________________________
TIRE SIZE: _____________________________________
SCCA MEMBER #: __________________________________
Award
Information:
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Cash awards are presented to the 1st and 2nd place drivers per race in SCCA U.S. Majors Tour
competition.
All eligible 2015 Conference Champions will also receive a $500 award.
A minimum of three starters in class are required to claim 1st place awards, five cars are required to
claim 2nd place awards.
This contingency program is verified by SCCA and paid by Goodyear Tire. For payout details or to
ask questions, please call (800) 770-2055.
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

PAYOUT SCHEDULE
EP, FP, HP, GT1, GT2, GT3, GTL, FM, P2, SRF, SRF3
1st
2nd
$300
$100
By signing below, I understand and agree to the conditions of the Goodyear Tire Contingency program and acknowledge that I have
never been compensated for the above claim.
DRIVER/CAR OWNER SIGNATURE
DATE
The named competitor has met all program requirements as verified on-site by:
TECH OFFICIAL SIGNATURE
SUBMIT TO:
SCCA MEMBER NUMBER
SPORTS CAR CLUB OF AMERICA
Attn: Club Racing Contingency Claims
6620 SE Dwight St
Topeka, KS 66619
FAX: (785) 232-7213
DATE
Please copy this form as needed for submission of
additional claims. Signatures may not be copied.