PLEASE PRINT
Name: ___________________________________________________________________
                                                       ^{First                                                                         Last}
Address: __________________________________________________________________
                                                                            ^{Street City State Zip}

Birth date: _________  Phone: (      )__________   E-mail:  _________________________
                 ^{Month Day Year}

As of January 1, 2008; yearly membership to OVRCCC costs $40.00* for adults and $10.00 a year for those 12 and under (Parent must be member as well).

Membership entitles one to discounted race entry fees, eligibility to hold club offices, voting privileges, off-hours access to the track and ability to serve on rules committees. Each member is entitled to one e-mail account (access to the internet or internet connection is NOT provided). Complete race rules and regulations can be downloaded from the web site, if member does not have access to the internet an attempt will be made to furnish a copy to the member.

Can you volunteer any time and/or materials to assist the club?  Yes  No

What classes are you interested in running? Please circle.

 1/12  1/10  1/8  1/18 Micro  1/18 Trucks  Oval  T-Spec  Buggy  Touring Car  Dirt  Monster Truck  Mod Monster Truck  Stadium Truck  Carpet  Nitro  Electric  Off-Road  Asphalt

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                                        ^{Please Sign**                                                                            Date}