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NCMP 125 LO206 Endurance Race Pre-Entry Form October 28-29

Personal Information

Team Manager
Team Name
Driver #1 Name
Driver #2 Name
Chassis Name
Address
 
City
State / Zip   /
Team Manager Phone
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
(Pre-Entrys Must be Received
two days before the Event!)
LO206 Entry
PLEASE SELECT CLASS!(
check box & select class)
(
DOES NOT INCLUDE PIT PASS!)

$500.00 - Includes 1 set of Bridgestone YLC 450/710x5 Tires

Transponder Rental
(
$16.05 per kart)
Two Day Pit Pass - You can also wait until you get to the track to buy passes

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