Madera Speedway Open Comp Entry Form

Click here for the rules and payout for all three classes

Note; every driver in each class must fill out an entry form......

Driver Name ________________________________________________________

Class / check each class you are racing in - Late Models ($100 at the track)_____Hobby Stock ($70 at the track)_______ 4-Cylinders ($60 at the track)________ (Drivers must enter in each class they plan to race)
Car Number___________ Car Number second division________ Car number third division________

Social Security or tax ID number________________________________

Address_____________________________________________________

City__________________________ Zip _____________________

Phone Number _________________________________________

Check Amount _______________________________

Credit Card Amount ___________________________

Type of Credit Card ____________________________

Billing Address ________________________________
_____________________________________________

Credit Card # _________________________________

Name on Card ________________________________

Exp. Date on Card _____________________________

Please Print and take to the track with you.