TDC Registration Form

Class of Competition

Contestant Name

First

Last

Preferred Nickname

Address (Information will be mailed to this location)

Address Line 1

Address Line 2

City

State/Province

Zip/Postal

Phone

Email

Spouse's Name

Children's Name(s)

Company Contact Name

Company Contact Phone

Company Contact Email

Terminal Address

Address Line 1

Address Line 2

City

State/Province

Zip/Postal

Lifetime Safe Driving Miles

# of Years in Trucking Industry

# of Preventable Accidents

# of Non-Preventable Accidents

Date of Last Accident

List unusual experiences, aid to motorists, acts of heroism, etc.

Awards Received

Hobbies

Strangest Cargo Hauled

Volunteer Experience

Past TDC Experience

Year / State / Competed Class / Competed Rank / Volunteer Role - List each event you've participated in on separate lines.

You must attach a copy of your current MVR showing: 1) Your name and/or signature; and 2) class of CDL (or license if SVDC applicant) and any endorsements. Applications will not be complete until MVRs are received by NTA.

I have my MVR and will attach it in the File Upload section below.

I do not have my MVR.

If you do not have your MVR, please provide your contact information for your CLDIS MVR. (Name, Email, Phone are required)

File Upload

Maximum file size: 52.43MB

You must attach a copy of your current MVR showing: 1 Your name and/or signature; and 2) class of CDL (or license if SVDC applicant) and any endorsements. Applications will not be complete until MVRs are received by NTA.

Agreements and Release: In consideration of my being permitted to participate in the American Trucking Association’s (ATA) National and/or Nevada Truck Driving Championships (TDC) or Step Van Driving Championship (SVDC) and be eligible for awards offered to participants, I hereby stipulate and agree to the following:

I acknowledge that I am not in the employ of ATA or NTA.

Both as to myself and my heirs and personal representatives, I release ATA, its directors, employees, agents and/or any of its affiliates and the Nevada Trucking Association, its directors, employees, agents and/or any of its affiliates from any and all liability and any right of action that may arise from any damage or injury which I may receive while attending or participating in the Nevada TDC or National TDC / National SVDC.

I grant the Nevada Trucking Association and ATA and its designated agencies exclusive right to make use of information about myself and of photographs supplied with this entry form, along with photographs subsequently taken under ATA or NTA’s direction, in publicity and advertising activities. I further agree to make myself available for publicity enterprises arranged by NTA or ATA, with newspaper and magazine writers and radio and television personnel.

I grant the Nevada Trucking Association and the ATA the right to examine my CDL and MVR for the purposes of determining my eligibility to compete at both the state and National TDC or SVDC.

I will be bound by all orders, rules and regulations governing ATA’s National and NTA’s TDC or SVDC while participating in said competitions.

Certification by Contestant: I certify that:

I have been continuously employed as a truck or step van driver by my present employer during the 12 months prior to the 2024 TDC.

I have driven and performed the regular duties of a truck or step van driver during the 12 months prior to the 2024 TDC.

I have not been away from the regular duties of a professional truck driver beyond an aggregate of 30 calendar days during the 12 months prior to the 2024 TDC.

I have not been involved in a preventable fleet motor vehicle or motor carrier vehicle accident during the 12 months prior to the 2024 TDC.

I have the proper CDL (DL if SVDC) plus required endorsement(s) for the class of competition.

I hold a CDL (DL if SVDC) from or have been occupationally domiciled in the state of Nevada.

I have not served as a member of any State Trucking Associations Truck Driving Championships Committee since January 1, 2024.

I have not received any form of pay, bonus, prize or other consideration for time spent in practice as set forth in the Truck Driving Championships Rules & Procedures. I agree that if I compete and win the Nevada TDC, that I will compete at the National TDC or SVDC (as applicable), unless disqualified or am detained due to a medical emergency, in which case I will notify the Nevada Trucking Association immediately. I acknowledge that any misstatement made with respect to my eligibility for the TDC or SVDC competition may result in the forfeiture of my right to compete or in my disqualification from said competition.

Signature

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