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SMVR


2018 MEMBERSHIP APPLICATION


Name___________________________________________Date____________
Spouse Name ____________________________________________________
Street___________________________________________________________
City________________________________State__________ZIP____________
Phone______________________________Cell_________________________
E-Mail __________________________________________________________
Car Year___________Make________________Model_____________________
Car Number__________Color of Car___________Engine__________________
My car is: Restored___________Replica____________Newly Built___________


S.M.V.R. dues are $30.00 for one year.

Paid member will be able to race at all S.M.V.R. sponsored events, attend and vote at meetings and receive all club newsletters.

Dues must be paid before member can race!

No pay no play!

Make checks payable to:

SMVR
Mail to:Mike McDowell

12633 166th St., Linwood, KS 66052

 

I, THE UNDERSIGNED, HEREBY RELEASE AND HOLD HARMLESS THE OFFICERS AND MEMBERSHIP OF S.M.V.R. OF ANY AND ALL RESPONSIBILITY FOR ANY DAMAGES OR INJURIES I MAY SUSTAIN AT ANY S.M.V.R. EVENT.


_____________________________________________
Signature


_____________________________________________
Print Name


 * * * Driver's Profile * * *


My Name: _________________________________________________ Car # _________________

I started driving in __________________________________________________________________________________________
A little about me ___________________________________________________________________________________________
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