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
KRA member (select YES or NO)	Yes No
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!)	KRA #13 September 23 (Sunday) KRA #14 October 7 (Sunday)
Kid Kart Pre-Entry (Does NOT include Pit Passes)	$30.00
1st Class Entry PLEASE SELECT CLASS!(check box & select class) (DOES NOT INCLUDE PIT PASS!)
$40.00 Please select 1st class Yamaha Masters Can Yamaha Junior Can (class 1) Yamaha Junior Can (class 2) Unlimited 125cc Shifter LO206 CIK Senior LO206 CIK Masters LO206 Senior Junior Novice Junior Novice Sportsman Yamaha Rookie LO206 Junior LO206 Sportsman TaG Heavy TaG Senior TaG Senior Super Lite TaG Junior Yamaha Jr. Sportsman (class 1) Yamaha Jr. Sportsman (class 2) Yamaha Senior Can
2nd Class Entry (check box & select class)
$35.00  Please select 2nd class ***NONE Yamaha Masters Can Yamaha Junior Can (class 1) Yamaha Junior Can (class 2) Unlimited 125cc Shifter LO206 CIK Senior LO206 CIK Masters LO206 Senior Junior Novice Junior Novice Sportsman Yamaha Rookie LO206 Junior LO206 Sportsman TaG Heavy TaG Senior TaG Senior Super Lite TaG Junior Yamaha Jr. Sportsman (class 1) Yamaha Jr. Sportsman (class 2) Yamaha Senior Can
3rd Class Entry (check box & select class)
$35.00 Please select 3rd class ***NONE Yamaha Masters Can Yamaha Junior Can (class 1) Yamaha Junior Can (class 2) Unlimited 125cc Shifter LO206 CIK Senior LO206 CIK Masters LO206 Senior Junior Novice Junior Novice Sportsman Yamaha Rookie LO206 Junior LO206 Sportsman TaG Heavy TaG Senior TaG Senior Super Lite TaG Junior Yamaha Jr. Sportsman (class 1) Yamaha Jr. Sportsman (class 2) Yamaha Senior Can Micro Swift Mini Swift KA100 Senior KA100 Junior
4th Class Entry (check box & select class)
$35.00 Please select 4th class ***NONE Yamaha Masters Can Yamaha Junior Can (class 1) Yamaha Junior Can (class 2) Unlimited 125cc Shifter LO206 CIK Senior LO206 CIK Masters LO206 Senior Junior Novice Junior Novice Sportsman Yamaha Rookie LO206 Junior LO206 Sportsman TaG Heavy (Class 1) TaG Senior (Class 1) TaG Senior Super Lite TaG Junior Yamaha Jr. Sportsman Yamaha Jr. Sportsman Yamaha Senior Can
Transponder Rental ($16.05 per driver)	Please make selection No Transponder Needed 1 Transponder Rental - $16.05
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 - $12 2 passes - $24 3 passes - $36 4 passes - $48