2008 SEMRA Sprint Registration

SEMRA 2010 Event Pre-Entry Form

Emergency Contact Name:

Emergency Contact Phone Number:

Bike Make: Model/Engine:

Sponsor: Tires:

Number of classes entered:

1 2 3 4 5 6 7 8 9

Please enter your bike's number for each class entered.

Spec HW	Kids Novice A	Formula 1	Thumper 136
Spec LW	Kids Novice B	Formula 2	Thumper 150
SuperMini	Adult Novice	GP85	Supermoto
Kids Expert	Kids Cup
Rent Transponder at track $15.00 Use personal AMB Transponder $5.00 scoring fee Your transponder number:
Fill out the form and click submit, then see Payment Options below. If you make a mistake just resubmit the corrected complete form.

SEMRA Classes Entered	Pre-Entry Fee	At Track Fee cash only
First Class Second Third+ Transponder Rental Scoring Fee	$40.00 $15.00 $5.00 $15.00 (includes scoring fee) $5.00	$50.00 $20.00 $10.00