Registration

Colo. Outlaw Racing Assoc. (CRA)

2012 Registration Form (after 2/1/2012)

Modified $ 115.00 Stock Car $ 115.00 Dwarf $ 115.00 1200 Outlaws $ 100.00 High Plains Midget $ 100.00 Hobby Truck $ 100.00 Hornet $ 75.00 1200 Outlaws/H.P.M. $ 150.00 (fees listed are for after 2/1/2012 deadline)

Car #: 1st Choice_____________2nd Choice ______________3rd Choice________________

Driver: (Please Print Legibly) :_________________________________________________________________________

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

Address: _____________________________________________City, State, Zip: _______________________________

Home #: (____)__________________ Work #: (____)___________________E-mail _____________________________

Signature__________________________________________________________________________________________

Name /Company Name:_______________________________________________________________________________

SSN/Fed ID: ___________________________________________ Date of Birth: __________/_________/_________

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 2012 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.

____________________________________________ ________________________________________________

Make check/money order payable to C.R.A. 18245 E. Hwy. 94 Colo. Springs, CO 80930