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 If you are a KRA member please do not change your kart number from your membership sheet unless asked by a KRA official or you notify scoring	- 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!)	Saturday June 26th
1st Class Entry PLEASE SELECT CLASS!(check box & select class) (DOES NOT INCLUDE PIT PASS!)
$35.00 Please select 1st class Rotax Senior Rotax Mini Max Rotax Junior Rotax Masters Rotax Micro Max Rotax DD2
2nd Class Entry (check box & select class)
$30.00  Please select 2nd class ***NONE Rotax Senior Rotax Mini Max Rotax Junior Rotax Masters Rotax Micro Max Rotax DD2
3rd Class Entry (check box & select class)
$30.00 Please select 3rd class ***NONE Rotax Senior Rotax Mini Max Rotax Junior Rotax Masters Rotax Micro Max Rotax DD2
Transponder Rental ($10.70 per driver)	Please make selection No Transponder Needed 1 Transponder Rental - $10.70
Raceday Only Pitpass Driver or Crew - If you plan on practicing the day before the KRA Race please purchase pitpasses at the track. You save $2.00 per pass!	Please make selection No Pit Passes Needed 1 pass - $10 2 passes - $20 3 passes - $30 4 passes - $40