MCCOOK SPEEDWAY
2012 DRIVER REGISTRATION
Drivers Name__________________________________________________________________
Mailing Address________________________________________________________________
City, State, Zip__________________________________________________________________
Telephone________________________ E-Mail_______________________________________
Owners Name (If different from Driver) _____________________________________________
Mailing Address_________________________________________________________________
City, State, Zip__________________________________________________________________
Telephone_________________________E-Mail_______________________________________
	Drivers Social Security Number___________________required for 1099
	Owners Social Security Number __________________required for 1099
	(We must have Social Security # or you will not get paid)
Winning check made to Driver_____________ Owner___________
Registration fee			Before April 1st		After April 1st
Class
_____IMCA Modified			$45_____		$60_____
_____IMCA Stock Car			$45_____		$60_____
_____IMCA Hobby Stock			$45_____		$60_____
_____IMCA Sport Mod			$45_____		$60_____
_____305 Sprint Car			$45_____		$60_____
		Check#______________		Cash_________
Make Checks payable to McCook Speedway, 208 West 1st McCook NE   69001
Registration is for driver not car, Driver must be registered for each class they run
Registered Car Number_________			2nd Choice_________
Reserved Parking Spot $50     Yes______		No______ Driver must put car number			or Name on fence in front
					of Parking spot by the 3rd
					race or the space will be open