Autocross Scramble - SWR FUNDRAISER Registration Form

Sanction(s): 14 Events Early Registration <= 9/8/2018, 7 Events Early Registration, Extra Lunches, NCCC Enthusast Membership, Sat XCross 1, Sat XCross 2, Sat XCross 3, Sat XCross 4, Sat XCross 5, Sat XCross 6, Sat XCross 7, Sun XCross 10, Sun XCross 11, Sun XCross 12, Sun XCross 13, Sun XCross 14, Sun XCross 8, Sun XCross 9
Entrant # 1 Car Number: Registration $
Entrant # 2 Car Number: Registration $
 Total$

1 Personal Information
 
Entrant # 1:
NCCC number:      
(Format: RR-CCC-MMMM)
First: Last:
Address:
City: State: Zip:
Phone: Email:
 
Entrant # 2:
NCCC number:      
(Format: RR-CCC-MMMM)
First: Last:
Address:
City: State: Zip:
Phone: Email:
 

2 Car InformationNon-Corvettes are either Metal (Men's Class) or LMetal (Ladies Class) and are NOT included in NCCC Results.
 Entrant #1:Entrant #2:
  Year: Make: Model: Class:          Year: Make: Model: Class:         

3 Events
14 Events Early Registration <= 9/8/2018 Entrant 1: $160.00                                                                     14 Events Early Registration <= 9/8/2018 Entrant 2: $160.00                                                                     
7 Events Early Registration Entrant 1: $90.00                                                                     7 Events Early Registration Entrant 2: $90.00                                                                     
Extra Lunches Entrant 1: $8.00                                                                     Extra Lunches Entrant 2: $8.00                                                                     
NCCC Enthusast Membership Entrant 1: $35.00                                                                     NCCC Enthusast Membership Entrant 2: $35.00                                                                     
Sat XCross 1 Entrant 1: $15.00                                                                     Sat XCross 1 Entrant 2: $15.00                                                                     
Sat XCross 2 Entrant 1: $15.00                                                                     Sat XCross 2 Entrant 2: $15.00                                                                     
Sat XCross 3 Entrant 1: $15.00                                                                     Sat XCross 3 Entrant 2: $15.00                                                                     
Sat XCross 4 Entrant 1: $15.00                                                                     Sat XCross 4 Entrant 2: $15.00                                                                     
Sat XCross 5 Entrant 1: $15.00                                                                     Sat XCross 5 Entrant 2: $15.00                                                                     
Sat XCross 6 Entrant 1: $15.00                                                                     Sat XCross 6 Entrant 2: $15.00                                                                     
Sat XCross 7 Entrant 1: $15.00                                                                     Sat XCross 7 Entrant 2: $15.00                                                                     
Sun XCross 10 Entrant 1: $15.00                                                                     Sun XCross 10 Entrant 2: $15.00                                                                     
Sun XCross 11 Entrant 1: $15.00                                                                     Sun XCross 11 Entrant 2: $15.00                                                                     
Sun XCross 12 Entrant 1: $15.00                                                                     Sun XCross 12 Entrant 2: $15.00                                                                     
Sun XCross 13 Entrant 1: $15.00                                                                     Sun XCross 13 Entrant 2: $15.00                                                                     
Sun XCross 14 Entrant 1: $15.00                                                                     Sun XCross 14 Entrant 2: $15.00                                                                     
Sun XCross 8 Entrant 1: $15.00                                                                     Sun XCross 8 Entrant 2: $15.00                                                                     
Sun XCross 9 Entrant 1: $15.00                                                                     Sun XCross 9 Entrant 2: $15.00