Registration - Dirt Series

JOIN US --->

Registration Form

First Name

Last Name

Date of Birth

PayPal Email Address

This will be where payouts will be sent

If you make weekly payout when do you want paid?

Each Week At End of Series

------ SHIPPING ADDRESS ------

Street Address

123 Main St.

City

State

Zip Code

12345

iRacing Account Name

iRacing Customer ID

Number Choice

Numbers Only (0-999)

Upload Your Car Image - Not Required

USED ON REGISTRATION FLYER

Your .tga wrap file - Not Required

USED FOR BROADCAST TICKER

Your Current Team - Not Required

Your Nickname - Not Required

Entry Fee Must be Paid on Next Page to be Registered