Those who bring sunshine to the lives of others cannot keep it from themselves. J. M. Barrie
Idea Transcript
Car Class
Junction Motor Speedway PO Box 524 Sutton, NE 68979 402-773-5538 ext. 4
Car Number
JUNCTION MOTOR SPEEDWAY 2018 SEASON REGISTRATION Car Number: _________________ Class:_______________________________ ________________________ Years Raced at JMS in Current Class Type
Fee
IMCA License
Sport Compact
$25.00
$60.00
Hobby Stock
$35.00
$85.00
Sport Mod
$50.00
$90.00
Modified
$50.00
$115.00
Late Model
$50.00
Trans Agree. Paid?
Check #/Cash Amount
Car #:______
Rookie? ____ Yes
____
Unsanctioned
Cash Amount:___________________________
No
Check Amount/Number:___________________________
Driver Information: Must Be Filled Out Completely
DATE:_______________________
Driver Name:_____________________________________________________________________________ Cell Phone Number:______________________________ Home Phone:______________________________ Address:_____________________________ City:_____________________ State:_______ Zip:__________ Social Security Number:____________________________________________________________________ IMCA LICENSE #:_____________________________ Ar e you a Rookie in your class?:______________ Driver Jacket Size:_______________________________
W9 Information (Must Be Filled Out By Person Receiving Check) Check Made Out To:___________________________________________________________________ Address:_____________________________ City:_____________________ State: ______ Zip:___________ Phone Number:_______________________________ SSN/ Tax ID:____________________________ *Transponder Pouches are mandatory. If you do not have one, they are available for purchase for $20.00 on each race day. **Must fill out Transponder Agreement prior to racing. Agreement separate from this form. Rev’d by_______________________ Computer:
Excel:
Please Send Registration Form with Payment To: Junction Motor Speedway PO Box 524, Sutton NE 68979