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 #14 - Sunday October 15th
Kid Kart Pre-Entry (Does NOT include Pit Passes)	$37.00
1st Class Entry PLEASE SELECT CLASS!(check box & select class) (DOES NOT INCLUDE PIT PASS!)
$49.00 Please select 1st class Yamaha Masters KA100 Junior KA100 Senior KA100 Masters 125cc Shifter LO206 CIK Senior LO206 CIK Masters LO206 CIK Light LO206 CIK Sportsman LO206 Super Heavy LO206 Super Masters LO206 Junior CIK LO206 Cadet CIK TaG Heavy TaG Senior TaG Junior Mini Swift Micro Swift Unlimited
2nd Class Entry (check box & select class)
$44.00  Please select 2nd class ***NONE Yamaha Masters KA100 Junior KA100 Senior KA100 Masters 125cc Shifter LO206 CIK Senior LO206 CIK Masters LO206 CIK Light LO206 CIK Sportsman LO206 Super Heavy LO206 Super Masters LO206 Junior CIK LO206 Cadet CIK TaG Heavy TaG Senior TaG Junior Mini Swift Micro Swift Unlimited
3rd Class Entry (check box & select class)
$44.00 Please select 3rd class ***NONE Yamaha Masters KA100 Junior KA100 Senior KA100 Masters 125cc Shifter LO206 CIK Senior LO206 CIK Masters LO206 CIK Light LO206 CIK Sportsman LO206 Super Heavy LO206 Super Masters LO206 Junior CIK LO206 Cadet CIK TaG Heavy TaG Senior TaG Junior Mini Swift Micro Swift Unlimited
4th Class Entry (check box & select class)
$44.00 Please select 4th class ***NONE Yamaha Masters KA100 Junior KA100 Senior KA100 Masters 125cc Shifter LO206 CIK Senior LO206 CIK Masters LO206 CIK Light LO206 CIK Sportsman LO206 Super Heavy LO206 Super Masters LO206 Junior CIK LO206 Cadet CIK TaG Heavy TaG Senior TaG Junior Mini Swift Micro Swift Unlimited
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 - $15 2 passes - $30 3 passes - $45 4 passes - $60