Personal Information

Driver's Name
Driver's Birth Date
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	October 19-20
Class Entry PLEASE SELECT CLASS (check box & select class) (DOES NOT INCLUDE PIT PASS!)
Please select class Yamaha Junior Sportsman - $100.00 Yamaha SSX Light (14 and Up) - $100.00 TaG Senior - $100.00 Yamaha Masters - $100.00
Transponder Rental ($10.70 per driver)	Please make selection No Transponder Needed 1 Transponder Rental - $16.05
Two Day Pitpass Driver and/or Crew, You can also wait to buy your pit passes at NCMP	Please make selection None, Will Purchase at NCMP 1 pass - $18 2 passes - $36 3 passes - $54 4 passes - $72

Classes and Tire Sizes -
Yamaha Junior Sportsman YLC 450x5
Yamaha Senior SSX Light YLC 450/710x5
TaG Senior YLC 450/710x5
Yamaha Masters YLC 450/710x5

All classes must run Bridgestone YLC Tires (competitors will supply their own tires, new or used).