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2017 RoboPong 200 Presented by Bridgestone Entry Form - October 20-22, 2017

Team Information

Team Name
Team Manager (person to contact for questions)
Drivers Name (maximum 4 drivers)
Co Driver's Name
Co Driver's Name
Co Driver's Name
Chassis Brand
Engine Type
Address
 
City
State / Zip   /
Daytime Phone of Team Manager
E-mail of Team Manager (We are having trouble with Yahoo accounts bouncing back, please leave the ".com" off your email if you are having trouble with your entry bouncing back)
Transponder # (if you own one)
Credit Card Number
(VISA, MC, DISCOVER) NO AMEX!
Expiration Number
CCV Three Digit Security
Code on Back of Card
(VISA, MASTERCARD or DISCOVER)
VERY IMPORTANT!
All numbers must be 1 or 2 or 3 digits - No letters allowed!
Please give your desired kart number
- 1st choice
- 2nd choice

Event Information (check all applicable boxes)

Race Date

Class Entry (check box)
(
DOES NOT INCLUDE PIT PASS!)

$696.97 Entry Includes 1 set of YLC tires (includes sales tax)

Transponder Rental
(
$10.70 per team)
Two Day Pitpass
Driver and/or Crew
You can also wait to buy your pit passes at NCMP

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