MCCOOK
SPEEDWAY
2008 DRIVER REGISTRATION FORM
Driver's
Name___________________________________________________________
Mailing address__________________________________________________________
City, State, Zip___________________________________________________________
Telephone
Number______________________email:_____________________________
Owner's
Name________________________________Address_____________________
City, State,
Zip__________________________________________________
Phone Number_________________ Social Security #_____________________required for 1099
WINNING
CHECKS TO BE MADE PAYABLE TO:____OWNER____DRIVER
REGISTRATION FORM MUST BE FILLED OUT COMPLETELY OR NO PAY
REGISTRATION FEE Before April 4 After April 4
CLASS: _____IMCA MODIFIED $45.00 $60.00
_____IMCA STOCK CAR $45.00 $60.00
_____IMCA HOBBY STOCK $45.00 $60.00
_____CLASSIC MODIFIED $45.00 $60.00
_____MINI-TRUCK $45.00 $60.00
PAYMENT CHECK # ____________________ CASH________________
Checks Payable to: 5G Racing Box 1183, McCook, NE 69001 308-345-4758 or 350-1811
REGISTRATION IS FOR DRIVER NOT CAR. DRIVER MUST BE REGISTERED FOR EACH CLASS THEY RUN.
Reserved Parking available: $50 Yes____ No____ (Car number must be placed on Fence by 3rd race)
Requested
Car Number:
Culbertson Speedway
2008 REGISTRATION FORM
Jim Lewis, Fairboard President
Driver's
Name___________________________________________________________
Mailing address_____________________________________________________________
City, State, Zip______________________________________________________________
Telephone
Number______________________email:________________________________
Owner’s
Name________________________________Address_______________________________
City,
State, Zip__________________________________________________
Phone Number_________________ Social Security #_____________________required for 1099
REGISTRATION FORM MUST BE FILLED OUT COMPLETELY OR NO PAY
REGISTRATION FEE Before April 21 After April 21
CLASS: _____IMCA MODIFIED $40.00 $50.00
_____IMCA STOCK CAR $40.00 $50.00
_____IMCA HOBBY STOCK $40.00 $50.00
_____CLASSIC MODIFIED $40.00 $50.00
_____MINI-TRUCK $40.00 $50.00
PAYMENT CHECK # ____________________ CASH________________
REGISTRATION IS FOR DRIVER NOT CAR. DRIVER MUST BE REGISTERED FOR EACH CLASS THEY RUN
Requested
Car Number:
Checks Payable to: Culbertson Speedway, PO 366, Culbertson, NE 69024 Phone 308-278-2675