Arrive & Drive Racing League – Membership Registration
Personal Information
Name
*
First
Last
Driver's Name
*
Email
*
Address
*
Street Address
Address Line 2
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Phone #1
*
Phone #2
Date of Birth
*
MM slash DD slash YYYY
Weight (lbs.)
*
Age
*
Emergency Contact
Full Name
*
Phone
*
Karting History
Member Since (Year)
Racing Schedule Number
Licence Issued
Amount
Price:
*35% off Early Bird price $71.50 + HST (Nov 25 - Dec 02) | Regular Price: $110 + HST
Consent
Parent / Guardian’s Name
Members under 18 years of age must have their parent or guardian to fill out this application.
Agreement
*
I/We agree to respect Mosport Karting Centre Inc. and understand membership to Mosport Karting Centre racing league(s) is granted as a privilege to members who participate within the rules set forth in the 2021 Rules and Regulations.
Total
Total payable amount
HST 13%
Price:
$ 0.00 CAD
Coupon
Total including HST
$ 0.00 CAD
Email
This field is for validation purposes and should be left unchanged.
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