Registration

Colorado Outlaw Racing Association (C.R.A.) Registration Form

Owner $ 75.00 Owner/Driver $ 90.00 Driver $ 25.00 Hornet $ 50.00

Classification of Car: (circle one) Modified ~ 1200 Sprint ~ Stock Car ~ Hobby Truck~ Hornet

Car #: 1st Choice_____________ 2nd Choice ______________ 3rd Choice________________

Driver Name: Please Print Legibly_________________________________________________

Social Security number: _______-_____-_______ Date of Birth: ______/______/______

Address: ___________________________________City, State, Zip:____________________________

Home #: (____)_______________ Work #: (____)_________________E-mail ____________________

Signature___________________________________________________________________________

Owner: (If same as driver just mark "Same")

Name /Company Name:_______________________________________________________________

SSN/Fed ID: ___________________________________ Date of Birth: ________/_______/_______

Address: _______________________________City, State, Zip:________________________________

Home #: (____)_________________Work #: (____)_______________E-mail ______________________

Signature_____________________________________________________________________________

Sponsors: (for program):________________________________________________________________

Other sponsors:_______________________________________________________________________

I will abide by the rules of C.R.A. as listed in the 2010 rulebook for this racing season. I will not hold C.R.A., its promoters, 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 Colo. 1200 Outlaws 18245 E. Hwy. 94 Colo. Springs, CO 80930