Team Information

Please check the ENTRY LIST before you choose a kart number so you don't pick a number that is already used by another team! One or Two digit only, no letters.

Team Name
Team Manager (person to contact for questions)
Driver's Name
Co Driver's Name
Co Driver's Name
Co Driver's Name
Address
City
State / Zip	/
Daytime Phone of Team Manager
E-mail of Team Manager
Transponder # (if you own one)
Credit Card Number (VISA, MC, DISCOVER) NO AMEX!
Expiration Number
CCV Three Digit Security Code on Back of Card (VISA, MASTERCARD or DISCOVER)
VERY IMPORTANT! All numbers must be 1 or 2 digits - Not letters either! Please give your desired kart number (Please check the entry list to see if your number is still available first, no duplicate numbers!)	- 1st choice - 2nd choice

Event Information (check all applicable boxes)

Race Date or Race Number	September 27th, 28th (Saturday, Sunday)
Class Entry (check box) (DOES NOT INCLUDE PIT PASS!)
$300.00 TaG
Transponder Rental ($10.70 per team)	Please make selection No Transponder Needed 1 Transponder Rental - $10.70
Two Day Pitpass Driver and/or Crew	Please make selection 1 additional pass - $18 2 additional passes - $36 3 additional passes - $54 4 additional passes - $72