MARYSVILLE RACEWAY PARK
2011 REGISTRATION FORM

  DIVISION MEMBER TYPE

FEE

CAR NUMBER  

360 SPRINTS

OWNER/DRIVER

$70.00

CAR #

WINGLESS SPRINTS

OWNER/DRIVER

$70.00

CAR #

MINI STOCKS

OWNER/DRIVER

$70.00

CAR #

STREET STOCKS

OWNER/DRIVER

$70.00

CAR #

HOBBY STOCKS

OWNER/DRIVER

$70.00

CAR #

DRIVER ONLY*-List Division

$50.00

CAR #

PITMAN ONLY-List Division

$50.00

CAR #

*If you are both the owner and driver of the car, the membership cost is $70.00
Individual Owner is $70.00. Individual driver is $50.00

"*CAR NUMBERS WILL BE RESERVED IN ORDER OF REGISTRATION RECEIVED*

   

MEMBER INFORMATION

Name:
Address:
City:
Phone: (          )

OWNER INFORMATION (checks paid to car owner)

OWNER's NAME:
Address:
City:
Phone: (          )
Social Security # / Tax ID#:
Please list one name only. Checks issued only with tax id # or social security number

MEMBERSHIPS MUST BE PAID IN FULL BY APRIL 16, 2011
IN ORDER TO PARTICIPATE IN POINTS COMPETITION

RESERVED PIT SPACES $175.00 EACH/FIRST COME-FIRST SERVED BASIS

Number of spaces:
 
Make checks payable to: Marysville Raceway Park
P. O. Box 6209
Marysville, CA 95901
Phone #(530)743-1327