PCA Scrutineer - KCRPCA

Scrutineer Incident Report

Scrutineer Report

Search For: Event Date, Driver's Name, and Time

Date

First Name

Last Name

Time

Driver Information

Information in this section is populated from the Driver's Incident Report

First Name

Last Name

Email

Phone

Car Number

Class

Video in Car

Driver Hurt/Soft Tissue Damage

Track Information

Information in this section is populated from the Driver's Incident Report

Track

Date

Time

Session 1

Session 2

Session 3

Track Condition

Corner Number

Flag

Driver's Incident Report

Information in this section is populated from the Driver's Incident Report

# of Cars Involved

Car Left Course

Car Hit Barricade

Metal to Metal

Rub Out

Mechanical Failure

Driver's Account of Incident

Driver's Signature

Scrutinerre's Incident Report

Was there a mechanical failure? *

Yes

No

Level of Damage *

1

2

3

4

5

6

7

8

9

10

Description of Damage *

Upload pictures of the car

Maximum file size: 516MB

Scrutineer's Full Name *

Scrutineer's Signature *

If you are human, leave this field blank.

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