3030 North I-70 Frontage Road

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					IMI Motorsports Complex
5074 Road #8, Dacono, CO 80514
Fax# 303-833-0502 Phone# 303-833-4949
Email: imimotorsports@hotmail.com
http://www.imimotorsports.com


            IMI / The Club Series
           REGISTRATION FORM
NAME:                                                                 AGE(if under 18):
ADDRESS:                                                              PHONE: _____________________
CITY:                                            STATE:             ZIP CODE:____________________
KART #_______ TRANSPONDER #_________________ EMAIL:___________________________________
Emergency Contact:_________________________________________________________________
CLASS (check one):
___Outlaw (white)                       ___Kid Kart(white)                      ___ Kid Kart Comer 50(black)
___Jr 1 Lo206                           ___Jr 1 Honda(red)
___Jr 2 World Formula                   ___Tag Minimax (yellow)                 ___Tag Jr(blue)
___Tag Sr(red)                          ___Tag Masters(yellow)                  ___ DD2 Masters (yellow)
___DD2(black)                           ___125 Shifter(yellow)                  ___125 Shifter Masters(black)
___125 Shifter Nov (S5)(red)            ___Spec 125 Shifter(blue)               ___Spec 125 Heavy(yellow)
___Tag 4- Cycle(yellow)                 ___Rotax Mini Max(yellow)               ___Rotax Jr(blue)
___Rotax Sr(red)                        ___Rotax Master(yellow)
                              -PLEASE COMPLETE A SEPARATE FORM FOR EACH RACER-
Yearly Fee(If not already paid): $40.00 = ____ (Must be paid to collect points. Last day to signup for series points is June 6th NO Exceptions)
$60 IMI / The Club Bundle #2: 1 class entry + 1 10x20 pit spot=_________
EXTRA CLASS: $55.00 PER DAY X ____ = ______
$240 IMI / The Club Bundle #1: 1 class entry + 1 set MG Tires + 1 10x20 pit spot=_______
Extra PIT SPOTS: $15.00 PER DAY X ____ = ______
TRANSPONDER: $10.00 X ____ = ______ : (check one) OWN                    TRACKS ____ TRANS. #________________
PIT PASSES: $10.00 x         =          (NON-DRIVER) 5 & UNDER FREE
PRIOR DAY TEST AND TUNE: $35.00 X _____ = _____


TOTAL: $________________
Payment Method: Check#                 / __Credit Card (American Express, Discover, VISA, MasterCard)
Credit Card #                                                         Exp. Date:_________________
Card Billing Zip Code                             Name on Card:________________________________
Signature:_______________________________________________
-NOTE: CALL 303-833-4949 FOR PIT RESERVATIONS
FAX OR E-MAIL COMPLETED FORM TO: 303-833-0502 imimotorsports@hotmail.com

				
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posted:10/4/2011
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