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Registration Form
Fill in form and print out for mailing or use the pdf format here
Last Name: First Name:
Address:
City: State: Zip :
Home phone: Work phone :
E-mail address :
Miata year: Color: Name: Roll bar: Y N
Check if multiple driver car Co-driver name(s)
Car number preference, if any (0-999): 1st 2nd 3rd 4th 5th
Check if first choice is a permanent number on the Miata
If you would like to volunteer in any of these areas, please circle your choice:
CONTROL TOWER GRID REGISTRATION WHERE NEEDED
INSTRUCTOR (attach brief resume)
Experience: Racing license (list)
Professional Driving schools (list)
Performance driving events (location/number)
Autocross (number of events)

Please rate your performance driving ability: NOVICE INTERMEDIATE ADVANCED

Free T-shirt size: S M L XL XXL

Entry Fee ($180 prior to Jan 15, 2001, $240 after)

Extra lunches ($10 each)

Saturday Qty Sunday Qty

Extra T-shirts ($10 each)
M Qty
L Qty
XL Qty
XXL Qty
Sub Total
- Deposit
Total Due

Return this form (one per driver) with payment to*:

Ony Anglade
6424 Highview Terrace
Watauga, TX 76148
*Make all checks payable to Ony Anglade

Download Registration Form - File Size: 11K