Team Information

Team Manager (person to contact for questions)
Driver's Name
Address
City
State / Zip	/
Daytime Phone of Team Manager
E-mail of Team Manager
Transponder # (if you own one)
Credit Card Number (VISA, MC, DISCOVER) NO AMEX!
Expiration Number
CCV Three Digit Security Code on Back of Card (VISA, MASTERCARD or DISCOVER)
VERY IMPORTANT! All numbers must be 1 or 2 digits No letters either Please give your desired kart number	- 1st choice - 2nd choice

Event Information (check all applicable boxes)

Race Date or Race Number	July 21st, Wednesday
Class Entry (check box) (DOES NOT INCLUDE PIT PASS!)
$200.00
Transponder Rental ($10.70 per kart)	Please make selection No Transponder Needed 1 Transponder Rental - $10.70
Two Day Pitpass Driver and/or Crew (You can also wait and purchase at the track)	Please make selection 1 additional pass - $18 2 additional passes - $36 3 additional passes - $54 4 additional passes - $72