2017 Membership Renewal

                                                                         BAY CITIES RACING ASSOCIATION, INC.

                                                                          P.O. BOX 447, Little River, CA  95456

                                                                                  OFFICE-(209)830‑9928 

                                                                                                                                                                                                CAR #_______

APPLICATION FOR MEMBERSHIP

 

MIDGET:                                                                                     $175.00 After 3/1/17 $200.00

OWNER___________________  DRIVER_______________________

 

MIDGET LITE:                                                                            $175.00 After 3/1/17 $200.00

OWNER___________________  DRIVER_______________________

 

VINTAGE:                                                                                    $125.00 After 3/1/17 $150.00

OWNER___________________  DRIVER_______________________

 

NON‑PARTICIPATING:                                                               $ 90.00

MIDGET____  MIDGET LITE____  VINTAGE_______

 

NAME:________________________________________________________DATE:___________

ADDRESS:_____________________________________________________________________

CITY:___________________________STATE:__________________ZIP CODE:____________

SOCIAL SECURITY NO.:____________________________E-MAIL_______________________

PHONE NO. (AREA CODE):(W)_______________________(H)__________________________

O.K. to release Phone# ______Yes ______No

Mail Newsletter to my home address: ______Yes  _______No

 

________________________________________________

APPLICANT’S SIGNATURE

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