Facility Information:
Name of Facility
Contact Person
Telephone Number
Fax Number
Email Address
Website Address

Do you wish to remain anonymous?
YES
NO

Can name be used for general reference only?
YES
NO

Geographic location of facility: 
City
State / Province
Country ( If outside the USA )

Nearest Large City
 

Type of Facility: (choose all that apply)
Stand-alone Indoor Track(s)
Part of Family Entertainment Center
Part of Water Park
Other (Specify)

Base Population:
10-mile radius
20-mile radius

Annual Attendance:
Corporate
Leagues
Walk-in

Type of Building:
New construction
Yes
No

Retrofit
Yes
No

If yes specify building type
Warehouse
Department store
Other (Specify)

Do you own the building?
Yes
No

Are you leasing or renting?
Yes
No

Does the building have sprinklers?
Yes
No

Building Size:
Square Feet

Building Location
Building Location Main Street Freeway Cross RoadsMallIndustrial Park
If other, please explain
 

Length of Track
Track 1
Track 2
Track 3
Track 4
Other
 

Type of Track (Choose all that apply)
Oval Course
Road Race Course
Changeable Courses
Other (Specify) 
 

Kart Brand(s) Used  (List all manufacturers)
1.
2.
3.
 

Number of Karts
Gasoline
Propane
Electric
 

Kart Equipment (Choose all that apply)
Roll Bars
Seat Belts
Wrap-Around Bumpers
Automatic Kill Switches
Other (Specify)
 

Other Equipment
Helmets Required?
Yes
No
If yes what brand ?

Racing Suits Used?
Yes
No
If yes what brand ?

Neck Braces Required?
Yes
No
If yes what brand ?

Head Socks (Balacalva) Required?
Yes
No
If yes what brand ?
 

Power
Gasoline Engine Brand
Electric Motor Brand
Propane Engine Brand

Type of Operation (Choose all that apply)
Restaurant
Cocktail Bar
Snack Bar
Vending Machines
Souvenir/Gift Shop
Grandstands
Meeting Rooms
Number of Meeting Rooms
Other (specify)
 

Other Attractions: (Choose all that apply)
Video Games (Arcade) 
Simulators
Laser Tag
Mini-Golf
Movies/Videos
Outdoor Kart Track
Family Entertainment Center
Water Park
Batting Cages
Other (Specify): 
 

Timing System
Yes
No
If yes what brand ?
 

Type of Safety Barriers
Brand ?

Self-made Barriers
Yes
No
 

Building Heating/Air Conditioning (Choose all that apply)
Heat
Infra-Red
Gas-Fired
Electric
Solar

Air Conditioning
Yes
No

Fans
Yes
No
 

Piped-in Music
Yes
No
 

Average Spending Per Person Per Visit
Walk-in
Corporate
League
Other
 

Number of Personnel
Full Time
Part Time
 

Ages
Minimum Driver Age
 

Special Programs: (Choose all that apply)
Adult Driving School
Junior Driver School
Leagues
Other (Specify) 
 

Special Instructions For Patrons
Video Presentation
Presentation by Personnel
No instructions given
 

Advertising Budget
Newspaper $
Radio $
Television $
Direct Mail $
Other $
 

Length of Time From Concept to Completion (Choose One)
6 Months
1 Year
1.5 Years
2 Years
Other (Specify): 
 

General Comments: