2007 Membership Form ( Non Transferable)
Number __________ Paid ____________
A membership entitles you to compete in all events
Must be 18 years old or older
(if a minor needs to have completed the minor release by
Parents or Guardian)
Open to men and women
One form per person
A year membership begins May 1, 2007, ends April 30, 2008
A new season/renewal membership includes:
NSRA membership
card
NSRA Program Book
NSRA hat OR
T-shirt
NSRA classes - Points in
Finals
NSRA Rule Book
NSRA point fund - $ at the end of the year
NSRA year pit
pass
NSRA Newsletter
NAME OF MEMBER: ( Please
Print)_____________________________________________________
STREET ADDRESS:
__________________________________________________________________
CITY _________________________
State______
Zip Code ______________
Phone # ______________________
E-mail
Address _______________________
SLED RACING NUMBER: Choice # 1 _______ Choice #2__________ (based on availability)
PLACE (X) ON LINE FOR CORRECT MEMBERSHIP WANTED:
DRIVER $60 ________ Annual year member receives points in all NSRA point system
Place (X)
________ If renewal
NOTICE: Season paddock area passes at $40 per person (18 years or
older).
Number required: _______
(Each pit personnel must have their own paddock pass, does NOT include
general admission)
Member's Social Security Number: _________________________________
Driver's/Membership Release:
I _____________________________________ hereby elect to use said course of the day as per entered at my own risk, and hereby release the sponsor, the NSRA, together with their heirs, members, assigns, officers, representatives, agent or employees from all liability from injury - including death - or property damage received or reputation that may be received from al claims growing out of or resulting from entry at this entered NSRA sanctioned event.
Signature required: _________________________________________ Date: _____________
In case of emergency please contact the following person:
NAME ______________________________________________ RELATIONSHIP_________________
ADDRESS ___________________________________________ PHONE # _____________________
