Step 1 - Member Information
Step 1a - Minor Guardian Information
Step 2 - Category & Bib Number Choice
Step 3 - Payment
Step 4 - Review
Step 5 - Completion
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Name & Address

First Name: *
Last Name: *
Address 1: *
Address 2:
City: *
State: *
ZIP: *


Personal Information

Date of Birth: * / /
Gender: *
SSN (only required for payback classes): *


Contact Information

Day Phone: *
Evening Phone:
Cell Phone:
Fax:
E-Mail Address: *
Website:


Login Information

*Please write this information down, as you will need it to register for future events!*
Username: *
Password: *
Verify Password: *


Racing Information

Sled Brand:
Team Name:
Crew Members:
Major Sponsor (28 characters):
Other Sponsors (150 characters):
      

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