Address:_____________________________________
City:_______________State:_______Zip:___________
Phone:_______________________Email:___________
Birthdate:________________________Age:_________
Transponder #(if you own one)____________________
Classes:_______________________________________
______________________________________________
______________________________________________
Preferred Kart Number 1st:___________2nd:__________
If you have less than one year experience please check_____
By Voluntarily Signing Below I agree to abide by All Rules and
Regulations Set Forth By Kart Racers of America Series and Conduct
Myself in a Sportsman Like Manner.
Signature:_________________________ Date:_________
Please Check Here _____ If You Wish to Have a Reserved Pit Spot (64ft x 15ft) and
Enclose $120.00 for a Yearly Reserved Spot for 14 Race KRA Series
If you wish to reserve more than one spot write in the number here_______
Credit Card Company__________
Number ______________________________Exp Date___________
- or -
Make Checks Payable to:
4D Promotions Inc.
Mail to: Kart Racers of America
2650 West Main Street
Greenfield, IN 46140
765-987-8090 phone 765-987-8419 fax - www.newcastleraceway.com