Colo. Outlaw Racing Assoc. (CRA)

2014 Registration Form (revised 6/4/14)

Northern SportMod $ 70.00   Stock Car $ 70.00   Hobby Truck $ 60.00  Hornet $ 60.00 

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

Driver: (Please Print Legibly)

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

Driver Name: __________________________________________________________________

Address: _________________________________________City, State, Zip: _______________________________

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

Signature_________________________________________________________________________________

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

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

Name /Company Name:__________________________________________________________

Address: ____________________________________________City, State, Zip: ____________________________

Home #: (___)________________________________ Work #: (____)__________________________________

Email__________________________________________________________________________

Signature______________________________________________________________________

Sponsors: Main (for program):__________________________________________________________________

Other:__________________________________________________________________________________________

I will abide by the rules of C. R. A. as listed in the 2014 rulebook for this racing season.  I will not hold C. R. A., its promoter, El Paso County, 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 C. R. A. 18245 E. Hwy. 94 Colo. Springs, CO 80930

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