Abilene Speedway Registration Form
Please Print Legibly
Driver:
Social Security number:
_______-_____-_______ Date of Birth: ______/______/______
Driver Name:
_____________________________________________________________________
First
Middle
Last
Address:
______________________________City, State, Zip:__________________________
Home Phone:
(______)__________________ Work Phone: (______)____________________
E-mail
Address________________________________
Owner:
SSN/Fed ID:
________________________ Date of Birth: ________/_______/_______
Name /Company Name:
________________________________________________________
Address: ______________________________City, State, Zip:_____________________________
Home Phone: (______) Work Phone: (______)
Classification of
Car: (circle one)
IMCA
Modified IMCA Stock Car
So. Ltd SportMods
Pure Stock
Jr. Mini Stock
Car #:
1st Choice____________2nd Choice
_____________3rd
Choice _____________
Sponsors: Main Sponsor to
be listed in program:____________________________________
Other
sponsors: ______________________________________________________________
I will abide by the rules
of Abilene Speedway as listed in the 2008 rulebook for this
racing season. I will not hold
Abilene Speedway, its owners, or any 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.
Signed:_______________________________
Signed:_______________________________
(Participant)
(Track owner)
Registration
Fee $20.00