Personal Information

Driver's Name
Address
City
State / Zip	/
Phone
E-mail
Transponder # (if you own one) "ON FILE" IS NOT A NUMBER
Credit Card Number (VISA, MASTERCARD or DISCOVER) NO AMEX!
Expiration Date
CCV Three Digit Security Code on Back of Card
VERY IMPORTANT! Please give your desired kart number	- 1st choice - 2nd choice

Event Information (check all applicable boxes)

Race Date and Race Number	Sunday August 28th
Class Entry PLEASE SELECT CLASS (check box & select class) (DOES NOT INCLUDE PIT PASS!)
Please select class LO206 Masters Shifter TaG Senior TaG Junior Yamaha Heavy KA100 Junior KA100 Senior LO206 Cadet LO206 Junior LO206 CIK Senior LO206 Super Heavy LO206 Super Masters Micro Swift Mini Swift Class Number 1 $49.00
Please select class LO206 Masters Shifter TaG Senior TaG Junior Yamaha Heavy KA100 Junior KA100 Senior LO206 Cadet LO206 Junior LO206 CIK Senior LO206 Super Heavy LO206 Super Masters Micro Swift Mini Swift Class Number 2 $44.00
Please select class LO206 Masters Shifter TaG Senior TaG Junior Yamaha Heavy KA100 Junior KA100 Senior LO206 Cadet LO206 Junior LO206 CIK Senior LO206 Super Heavy LO206 Super Masters Micro Swift Mini Swift Class Number 3 $44.00
Transponder Rental ($10.70 per driver)	Please make selection No Transponder Needed 1 Transponder Rental - $16.05
Race Day Only Pit Pass	Please make selection None, Will Purchase at NCMP 1 pass - $15 2 passes - $30 3 passes - $45 4 passes - $60