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2017 Trucking Driving Championship Quick Facts Date: June 17, 2017 Start time: Registration begins at 9:00 a.m. Location: Winjean Trucking Company, 183 Airport Road, Buckhannon. Directions to Winjean Trucking: Exit 99 off I-79. Take RT33 east 10.5 miles to stop light (JenkinsFord on right and WV Department of Highways on left). Turn right onto Brushy Fork Rd. Drive 1.1miles and after passing the Armory, turn right onto Airport Road 7/7. Go 568 feet and turn left atthe Winjean Trucking sign. It is approximately 110 miles from Charleston and will takeapproximately one hour and 45 minutes. Drivers: Complete the enclosed participant form and an Entry & Release form for each driver.Return all forms along with an MVR for each driver by May 8th, 2017. Entry fees are 160 perdriver and will be billed once we receive your registrations. Lunch: WVTA provides lunch for all drivers and volunteers. Lunches are available for spectatorsfor 10 each and include hamburgers, chips and a drink. If you would like to order lunch forspectators, complete the lunch order form. Also, spectators can bring their own lunch if they wish. Dinner: The Awards Dinner will be held shortly after the competition. We will be having steaks,potato salad, baked beans, rolls and a drink. Tickets are 40 each. Complete awards dinner orderform. TDC and Safety Awards will be presented. Spectators: We have lots of space, so please bring your awnings, coolers, chairs and lot ofsunblock. There is also lots of space for the kids to play! Overnight Accommodations: We have rooms blocked at the Hampton Inn, located at 1Commerce Blvd., for both Friday, June 16th and Saturday, June 17th. The room rate is 109, whichincludes breakfast. If you would like to make a reservation, please call 304.473.0900. Whenmaking your reservation, please ask for one of the rooms under the WV Trucking Association. Theroom block will be released on June 12th, so make sure you get your reservations early.

Annual Truck Driving ChampionshipsJune 17, 2017Please use this form to advise us of the number of drivers you will be entering and list their names.This advance information is necessary in determining the amount of equipment and space that willbe required. Entry fees are 160 per driver.We plan to enter drivers in the 2017 WVTA Truck Driving Championships.Are you a member of the American Trucking Associations?YesNoHave you ever had a driver participate in a National Truck Driving Championship?YesNoNumber in each class:Straight TruckDriver Name Rookie? YesNo3-Axle Tractor Semi-trailerDriver Name Rookie? Yes No4-Axle Tractor Semi-trailerDriver Name Rookie? Yes No5-Axle Tractor Semi-trailer (van)Driver Name Rookie? Yes No5-Axle Tractor Semi-trailer (tank)Driver Name Rookie? Yes No5-Axle Tractor Semi-trailer (flatbed)Driver Name Rookie? Yes No5-Axle Tractor Semi-trailer (sleeper)Driver Name Rookie? Yes NoTwin TrailersDriver Name Rookie? Yes NoStep VanDriver Name Rookie? Yes NoIf more space is needed for additional driver names, please list on separate sheet andinclude above information.Name TitleCompany Name and DivisionMailing AddressCity State ZipTelephone FaxEmailReturn to:WVTA2006 Kanawha Boulevard, EastCharleston, WV 25311Fax: (304) 343-5810RETURN NO LATER THAN MAY 8, 2017If invoice for entry fee and banquet tickets should mailed to different address, list below:Company ContactAddressCity State ZipPhone EmailPlease note all information including driver and class, must be in our office no laterthan 5/8/17 to be entered into the Truck Driving Championship.

2017 Truck Driving Championships & Step Van Driving ChampionshipsEntry and Release Form(Be sure to complete Driver Information Sheet on reverse side)Contestant’s Name:Competition State:Preferred Nickname:Hosting State Assn.:Employer:Class of Competition (check one)Straight Truck5-Axle Tractor-SemitrailerFlatbed(Single 2-axle vehicle)(3-axle tractor & 2-axle 53’ semitrailer)(3-axle tractor & 2 axle flatbed semitrailer)3-Axle Tractor-Semitrailer5-Axle Sleeper Berth Tractor-SemitrailerTwin Trailers(2-axle tractor & 1-axle 28’ semitrailer)(3-axle sleeper tractor & 2-axle 53’ semitrailer)(2-axle tractor & set of 28’ semitrailers)4-Axle Tractor-SemitrailerTank TruckStep Van(2-axle tractor & 2-axle 53’ semitrailer)(3-axle tractor & 2-axle tank semitrailer)(Step or Package Van)CERTIFICATION BY EMPLOYER. I hereby certify that I am aware of the provisions of Chapter V, Truck Driving ChampionshipsEligibility Rules, of the ATA Truck Driving Championships Rules and Procedures, State and National and applicable appendixes including the Step Van Driving Championships rule summary; that the contestant named herein is eligible to compete under these rules; thatthe contestant’s employer is a member of an ATA-affiliated State Trucking Association, and that all information furnished about them istrue to the best of my knowledge and belief.Employer Mgr.’sSignature (NOT driver’s):Mgr.Title:AGREEMENTS AND RELEASEIn consideration of my being permitted to participate in the ATA’s National and/or its affiliates’ Truck Driving Championships (TDC) orStep Van Driving Championships (SVDC) and be eligible for awards offered to participants, I hereby stipulate and agree to the following:1.2.3.4.5.I acknowledge that I am not in the employ of ATA or a State Trucking Association.Both as to myself and my heirs and personal representatives, I release ATA, its directors, employees, agents and/or any of itsaffiliates and the State Association noted above, its directors, employees, agents and/or any of its affiliates from any and all liabilityand any right of action that may arise from any damage or injury which I may receive while attending or participating in said Stateor National TDC or National SVDC.I grant the State Association noted above and ATA and its designated agencies exclusive right to make use of information aboutmyself and of photographs supplied with this entry form, along with photographs subsequently taken under ATA’s direction, inpublicity and advertising activities. I further agree to make myself available for publicity enterprises arranged by ATA, withnewspaper and magazine writers and radio and television personnel.I grant State Association noted above and ATA the right to exam my CDL and MVR for the purposes of determining my eligibility tocompete at both the State and National TDC or SVDC.I will be bound by all orders, rules and regulations governing ATA’s National and/or its affiliates’ TDC or SVDC while participating insaid competitions.CERTIFICATION BY CONTESTANT. I certify that during the 12 months prior to the 2017 TDC:1.2.3.4.5.6.7.8.9.I have been continuously employed as a truck or step van driver by my present employer [exception: 11 of 12 months if previousemployer went out of business and all other eligibility requirements are met]; andI have driven and performed the regular duties of a truck driver or step van driver for at least 11 of the 12 months, and that myregular duties of a truck driver or step van driver constituted not less than 60% of my work hours and at least 1200 hours annually.I have not been involved in a fleet motor vehicle or motor carrier vehicle accident in the course of such employment.I have the proper class Commercial Driver’s License (if a SVDC applicant, not required), plus required endorsement(s) for the classof competition indicated above.That I hold a CDL from or have been occupationally domiciled in the state of . Occupational domiciledmeans the terminal, garage or other operating base from which the driver normally and usually works and/or is supervised.That the class of competition I am entering in 2017 is not a class in which I won at the state or regional TDC and/or competed atthe National TDC in 2015 and 2016 or 2014 and 2015; or if I am entering the step van class, I did not win the state or regional TDCand/or compete at the National SVDC in the step van class in 2015 and 2016. I understand that after winning two consecutiveyears at the State TDC and/or competing two consecutive years at the Nationals in that same class of competition, I am not eligibleto compete in that same class for one year if a step van competitor and two years if a competitor in any other class.I further certify that I have not received any form of pay, bonus, prize or other consideration for time spent in practice as set forth inthe ATA Truck Driving Championships Rules and Procedures, State and National.I agree that if I compete and win the State TDC, that I will compete at the National TDC or SVDC (as applicable), unless disqualified oram detained due to a medical emergency, in which case I will notify the applicable State Trucking Association immediately.I acknowledge that any misstatement made with respect to my eligibility for the TDC or SVDC competition may result in theforfeiture of my right to compete or in my disqualification from said competition.Driver’s Signature:Attach a photocopy of your MVR showing: 1) Your name and/or signature; and 2) Class of CDL (or License if SVDC applicant)Also attach a copy of your CDL.Form TR-1 American Trucking Associations (Rev. 12/16)

2017 ATA Truck Driving Championships & Step Van Driving Championships Driver Information FormContestant’s Name:Home Address:(first)(middle)(last)(number-street)Class of Competition:Home Phone:Competition State:E-mail:Employer:Married:Employer MainOffice (city)(state)(zip)Important:Company President:((city))(state)Cell Phone:YesNo((zip))Spouse’s Name:Will significant other attend the State TDC? Yes No National TDC? Yes NoList unusual experiences, aid to motorists or at accident scene, acts of heroism:(first)(middle)(last)Safety Director:(full name)(E-mail)Awards received:Safety Dir. trangest cargo ever hauled:Do you volunteer? Where/how:T-shirt size?Terminal Manager:(full name)Termin. Mgr Phone #:((E-mail))Jacket Size?How many times have you participated in a State rSVDC?Contestant’sHome Terminal:(number-street)(city)(state)Length of Servicewith Present Employer:Length of Servicein Trucking Industry:Number of Years withNo-Accident Record:Lifetime SafeDriving Miles:Number of Accidents:Preventable:(zip)Below and above Info is used at Nationals to determine ND Professional Excellence Award eligibility.Previous State/National TDC or SVDC in which you competed or volunteered:YearStateCompeted ClassCompeted RankVolunteer RoleNon-Preventable:Date of Last Accident:Usual Run:LocalPeddleLine-haul(Please attached separate history sheet if additional space is needed for above listing)Is your company a member of the StateTrucking Association?YesState:NoHave you been on the state Road Team?YesYears:NoHave you ever been a member of America’sRoad Team?YesYears:NoAre you interested in serving on America’s Road Team?YesNoHave you been on a company Road Team?Years:NoYesFor State and National publicity purposes include: Recent 2” X 3” (or larger) head and shoulder photograph (may be e-mailed as instructed by State Championships Committee or hosting State Trucking Association), and The name of your hometown newspaper:and the nearest large city to your hometown:Information sheet must be complete to be eligible for National competition!Form TR-2 - American Trucking Associations(Rev. 12/16)