Forms

membership form

PLAZA PARK RACEWAY, LLC.

2012 MICRO-SPRINT and JUNIOR MEMBERSHIP

DRIVER INFORMATION (1 FORM PER MEMBER PER CLASS)

 

NAME:________________________________  CDL#_____________________

 

MAILING ADDRESS:_____________________________PHONE:____________

 

CITY:___________________ST:_____ZIP:_________EMAIL:_______________

 

AGE:______DOB:_____________WINNINGS PAID TO:____________________

 

SS# OF PERSON RECEIVING WINNINGS:__________________________________

CAR INFORMATION

CLASS:_________________ENGINE:___________CAR#________YEAR:__________

 

CHASSIS:___________________________CAR OWNER:_________________________

WE MUST HAVE AN ANNUAL MINOR’S RELEASE FORM FOR ANY PERSON UNDER 18 YEARS OLD THAT ENTERS THE RESTRICTED PIT AREA (DRIVER OR CREWMAN) BEFORE PARTICIPATING IN AN EVENT WITH PLAZA PARK RACING ASSOCIATION, INC.

SPONSORS:

 

 

CAR # GOES TO MEMBER WHO REGISTERED FIRST.  PITS ARE ON A FIRST REQUEST BASIS.  IF YOU HAD A RESERVED PIT LAST YEAR, YOU WILL HAVE THE OPTION TO RENEW IF COMPLETED FORM & FEES ARE RECEIVED BEFORE FEBRUARY 15, 2012

MEMBERSHIP FEES

DRIVER ————————————————————————$50.00_________

OPTIONAL ANNUAL RESERVED PIT(ON BACK)

PIT #’S 1-9, 48-52, 54-55-PIT #____________ $80.00________

ALL OTHERS—————-PIT #_____________$60.00_________

TOTAL ENCLOSED: $________________

ENTRY FEES:

DRIVER (MEMBER)-$45.00                    DRIVER (NON-MEMBER)-$55.00

                                      PIT PASS(NON-DRIVER)-$20.00

YOU DO NOT HAVE TO BE A MEMBER TO GET PAID, BUT YOU MUST BE A MEMBER TO          RECEIVE POINTS!!

RECV. BY: ______________                                      DATE: _____________

PLEASE MAIL COMPLETED FORM WITH CHECK PAYABLE TO:

PLAZA PARK RACEWAY, LLC

1820 W. LACEY BLVD., #283

HANFORD, CA 93230