Sport Modified $ 50.00 Stock Car $ 50.00 Hobby Stock $ 50.00 Sport Compact $ 50.00 SO CO Karts $ 50.00 Car #: 1st Choice_____________2nd Choice ______________3rd Choice________________ Driver: (Please Print Legibly)Social Security number: _______-_____-_______ Date of Birth: ______/______/______ Driver Name: __________________________________________________________________ Address: ___________________________________________________City, State, Zip: _______________________________ Home #: (____)__________________ Work #: (____)_______________________E-mail _______________________________ Signature_________________________________________________________________________________ Owner: (If same as driver just mark "Same") SSN/Fed ID: ________________________ Date of Birth: ________/_______/_______ Name /Company Name:__________________________________________________________ Address: _______________________________________________City, State, Zip: ____________________________ Home #: (___)____________________________________ Work #: (____)______________________________________ Email__________________________________________________________________________ Signature______________________________________________________________________ Sponsors: Main (for program):_______________________________________________________________________ Other: __________________________________________________________________________________________________ I will abide by the rules of C.R.A. as listed in the 2022 rulebook for this racing season. I will not hold C.R.A., its promoter, the City of Pueblo, or any track officials responsible for any physical injury or damage to my vehicle(s). I understand a breathalyzer test may be required at any time. I understand refusal to take the test or failure of the breathalyzer test will result in disqualification with no pay or points. ________________________________________________ _________________________________________________ (Participant) (Promoter) Make check/money order payable to C.R.A. 18245 E. Hwy. 94 Colo. Springs, CO 80930 |