2010 Season Membership

Annual Membership fee is $35.00

Mail to:

i-90speedway

PO Box 144

Blue Earth MN 56013

Drivers Name, Date of Birth, Kart Number ,Class IKF or Clone

Name: ___________________________________________ Phone#:______________

Age _______ mo._________ Day__________ Year________

Address: ____________________________________ E-Mail: ___________________

City State Zip: ___________________________________________________________

Kart Number #______________  Class_________________

Member signature ______________________________________ Date ___________

Parents or Guardians