Racers Licensing Clinic Registration

Midwest Cafe Racing Association
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Only those paying online should complete this form. Those mailing in payments should complete a mail-in form.

2010 MCRA Racer's Licensing Clinic
Registration Form

This form must be completed in its entirety and turned into the tech inspector at the track. If you have mailed in or paid online, you will pick up your registration form at the registration area. If paying at the track, print and complete the mail-in form before arriving to save time.
Everyone must pass thru the registration area and receive an arm-band before entering the track.

(one form per rider)

Select Your Racer's Licensing Clinic Date(s)

Sun-May 23rd Sat-Jun 12th Sat-Aug 14th Sun-Oct 10th

Normal Track Day Class (select one):
                              Novice
                              Intermediate
                              Expert (Race license required to start in this group)

Rider Full Name:
Address:
City: State: Zip Code:

Phone: HOME CELL

eMail:

Emergency Contact: NAME
PHONE

Motorcycle (year, make, model):

Riding Experience (years):

If your bike is pre-numbered, what is your number? (EXAMPLE: Y234 = Yellow 234)

Required I have read the Track Day Handout and agree to comply with any guidelines for track day usage.

NOTE:
After you click "Send Registration Information",
print the following page for your records.

Safety equipment required (Novice, Intermediate & Expert): Full Leathers or Aerostitch type suit with either one piece or zip-together two-piece design, Full-Face Helmet, Leather Boots and Gloves.

NOTE: ALL bikes and equipment MUST pass an on-site safety inspection before being permitted on the track. This is a RAIN or SHINE event. NO REFUNDS.

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