Personal Information

Driver's Name
Address
City
State / Zip	/
Phone
E-mail
Transponder # (if you own one) "ON FILE" IS NOT A NUMBER!
Credit Card Number (VISA, MASTERCARD or DISCOVER) NO AMEX!
Expiration Date
CCV Three Digit Security Code on Back of Card
KRA member (select YES or NO)	Yes No
VERY IMPORTANT! Please give your desired kart number If you are a KRA member please do not change your kart number from your membership sheet unless asked by a KRA official or you notify scoring	- 1st choice - 2nd choice

Event Information (check all applicable boxes)

Race Date or Race Number (Pre-Entrys Must be Received by Friday Before the Event!)	KRA Race #4 (Makeup Race) October 4th KRA Race #14 October 5th
Kid Kart Pre-Entry (Does NOT include Pit Passes)	$24.00
1st Class Entry PLEASE SELECT CLASS!(check box & select class) (DOES NOT INCLUDE PIT PASS!)
$35.00 Please select 1st class Yamaha Pipe Senior/HPV Yamaha Masters SSX SSX Junior Can (class 1) SSX Junior Can (class 2) Unlimited F200 ICC 125cc Shifter 125cc Moto Shifter Cadet Junior Sportsman Briggs Flathead Heavy Senior Briggs Animal Heavy Senior Junior Novice Junior Novice Sportsman TaG Senior Sportsman TagUSA Masters TagUSA Senior Yamaha Jr. Sportsman (class 1) Yamaha Jr. Sportsman (class 2) Yamaha SSX Heavy Spec TaG Senior Spec TaG Masters
2nd Class Entry (check box & select class)
$30.00  Please select 2nd class ***NONE Yamaha Pipe/HPV Senior Yamaha Masters SSX SSX Junior Can (class 1) SSX Junior Can (class 2) Unlimited F200 ICC Shifter 125cc 125cc Moto Shifter Cadet Junior Sportsman Briggs Flathead Heavy Senior Briggs Animal Heavy Senior Junior Novice Junior Novice Sportsman TaG Senior Sportsman TagUSA Masters TagUSA Senior Yamaha Jr. Sportsman (class 1) Yamaha Jr. Sportsman (class 2) Yamaha SSX Heavy Spec TaG Senior Spec TaG Masters
3rd Class Entry (check box & select class)
$30.00 Please select 3rd class ***NONE Yamaha Pipe/HPV Senior Yamaha Masters SSX SSX Junior Can (class 1) SSX Junior Can (class 2) Unlimited F200 ICC Shifter 125cc 125cc Moto Shifter Cadet Junior Sportsman Briggs Flathead Heavy Senior Briggs Animal Heavy Senior Junior Novice Junior Novice Sportsman TaG Senior Sportsman TagUSA Masters TagUSA Senior Yamaha Jr. Sportsman (class 1) Yamaha Jr. Sportsman (class 2) Yamaha SSX Heavy Spec TaG Senior Spec TaG Masters
4th Class Entry (check box & select class)
$30.00 Please select 4th class ***NONE Yamaha Pipe Senior Yamaha Masters SSX SSX Junior Can (class 1) SSX Junior Can (class 2) Unlimited F200 ICC Shifter 125cc 125cc Moto Shifter Cadet Junior Sportsman Briggs Flathead Heavy Senior Briggs Animal Heavy Senior Junior Novice Junior Novice Sportsman TaG Senior Sportsman TagUSA Masters TagUSA Senior Yamaha Jr. Sportsman (class 1) Yamaha Jr. Sportsman (class 2) Yamaha SSX Heavy Spec TaG Senior Spec TaG Masters
Transponder Rental ($10.70 per driver)	Please make selection No Transponder Needed 1 Transponder Rental - $10.70
Raceday Only Pitpass Driver or Crew - If you plan on practicing the day before the KRA Race please purchase pitpasses at the track. You save $2.00 per pass!	Please make selection No Pit Passes Needed 1 pass - $10 2 passes - $20 3 passes - $30 4 passes - $40