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Next Event at NCMP
KRA Series Race #3 - Sunday, May 4th


2005 Cindy Wiegand Memorial TaG USA Race Entry Form

All Pre-Entries Must be Received No Later Than MIDNIGHT WEDNESDAY Before the TaG Race!! You CAN enter at the track.

Personal Information

Driver's Name
NKA will be comping pitpasses
for the Memorial TaG Race -
We do need a list of crew
members who need pitpasses!
Crew Member Name
Crew Member Name
Crew Member Name
Crew Member Name
Driver Address
 
City
State / Zip   /
Phone
E-mail
Transponder # (if you own one)
"ON FILE" IS NOT A NUMBER!
Credit Card Number
Expiration Number
CCV Three Digit Security
Code on Back of Card
(VISA, MASTERCARD or DISCOVER)
VERY IMPORTANT!
Please give your desired kart number
- 1st choice
- 2nd choice

Event Information (check all applicable boxes)

Race Date or Race Number
Class Entry

$150.00

Transponder Rental
(
$25 per driver)

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