MEMBERSHIP APPLICATION - Wakeeney Mini Speedway

2016
MEMBERSHIP
APPLICATION
NAME: ___________________________________________________________
ADDRESS: _______________________________________________________
CITY/STATE/ZIP: _________________________________________________
HOME PHONE # ______________________ CELL #: __________________
EMAIL ADDRESS:_________________________________________________
DRIVER NAME
CLASS
KART NUMBER
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(1or 2 DIGIT NUMBER)
-Annual Membership Fee $30.00 per family
-Pit passes will be $13.00
-Reserved Pit Spot Fee: $25
-Class Entry Fee: $20
-Non-Member kart/drivers will be $40.00/class
-We require new minor forms signed at the beginning of each race season.
-We require BIRTH CERTIFICATES for all Junior and Rookie Classes so please bring it to the first race.
Mail membership form and fees to the following address or bring to first race:
WaKeeney Kart Club
PO Box 183
WaKeeney, KS 67672
RESERVED PIT SPOT FEE: $25.00
Yes___________
No___________