Register Crew Member
This information will let us know more about you.
Crew Member
Emergency
Options
Association
Finish
Crew Information
Crew First Name
Crew Last Name
Suffix
Sr
Jr
III
Address Line 1
Address Line 2
Postal Code
City
State
Select State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Primary Phone
no dashes or spaces
Primary Email
Emergency Contact
Information is only shared with EMT staff.
Emergency First Name
Emergency Last Name
Primary Phone
no dashes or spaces
Preferred Hospital
Primary Doctor
Notes
Medications
By filling this form, I understand that the information used or disclosed may be subject to re-disclosure by the person or class of person or facility receiving it, and would then no longer be protected by federal privacy regulations
I may revoke this authorization by notifying the track/series in writing of my desire to revoke it. However, I understand that any action already taken in reliance on this authorization cannot be reversed, and my revocation will not affect those actions
Select
Name
Select all that apply
Price
Non-Driver Reduced Pit Pass & Discounted Nationals
$75.00
Season Pit Pass Flat Rate/Person (Crew, Fan, Sponsor) Valid Sundays & Nationals
$450.00
SLM - Season Pit Pass Flat Rate/Person (Crew, Fan, Sponsor) Valid 8 SLM Races & Nationals
$275.00
Line Total
$775.00
Processing Fee
$28.31
Total
$803.31
Driver Association
Who will you working with?
I am a
Pit Crew
Car Owner
Car Sponsor
Fan
Other
Division I am with
4 Cylinder Figure 8's
602 Craters
602 Late Models
American Super Cups
B - Track Barrel Race
Back Up Push Car Race
Back Up Race
Bandoleros
Big Car Figure 8's
Burn Out Contest
Bus Figure 8's
Figure 8's
Gauntlet
Hobby Stocks
HSRA
Late Models
Legends
Little Switzerland Ski Race
Midwest Truck Series
Push Car Race
Red Rover
Slinger Bees
Spectator 1-on-1's
Sportsman
Super Beez
Super Late Models
Trailer Race
Upper Midwest Vintage Racing Series
Vintage Modifieds
Whoop-Dee-Doo
Wisconsin Sport Trucks
Car Number
Driver Association
Payment
Card
Check/ACH
Name on the Card
Name as it appears on the card
Postal Code for Card
5 Digit Postal Code for the card
Name on the Account
Name as it appears on the account
Postal Code for Account
Zip code for the account
Consent to follow the rules.
Consent to electronic signature
I agree to all rules and terms of the Slinger Super Speedway.
Coupon Code
apply discount
Processing Fee:
$28.31
Total:
$803.31
