Owendale Speedway

Annual fee for car owner and driver $25.00 if registered before May 01, 2012 or $30.00 registration fee after that date.

No winnings will be awarded unless car owner and driver are registered, and this form is completely filled out.

Class: _______________________________ Car umber:_____________________________

Driver Name: _________________________ Street Address:___________________________

Town/City: ___________________________ State: ___________ Zip: ___________________

Telephone - Home: __________________________ Work: ____________________________

Social Security: _____________________________ Driver's percentage of earnings:_______

Driver's Signature: _____________________________________________________________
(By signing this form I verify S.S.# is correct and all info is accurate)
Car Owner's Name: _________________________ Address: __________________________

Town/City: ___________________________________ State: _________ Zip: _____________

Telephone - Home: ____________________________ Work: __________________________

Social Security: ____________________________ Owner's percentage of earnings:_______

Owner's Signature: ____________________________________________________________
(By signing this form I verify S.S.# is correct and all info is accurate)

Pit Crew Names: ______________________________________________________________

____________________________________________________________________________

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Class: ___________________________________ Car: ______________________________

Name: _____________________________________________ Age:____________________

Address: ___________________________________________ Birthday:________________

Town/City: _________________________________________ Motor size:_______________

Engine Builder: _______________________________ Chassis Builder:_________________

Car Owner: __________________________________________________________________

Crew Members: ____________________________________________________________________________

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Sponsors: (Include town) List main ones first - only two sponsors might be announced at a time.
1. _______________________________________________________________________

2. _______________________________________________________________________

3. _______________________________________________________________________

4. _______________________________________________________________________

Tracks where you compete regularly: _________________________________________

Accomplishments in racing: (track championships, fast time, etc.)

1. _______________________________________________________________________

2. _______________________________________________________________________

3. _______________________________________________________________________

Occupation & Location: ____________________________________________________

Name of spouse (if married) and children: _____________________________________

_________________________________________________________________________

Years racing: ______________________ type of cars raced: _______________________

Any further information you would like the fans to know about yourself or your crew:
___________________________________________________________________________

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