Register Driver

This information will let us know more about you.
To complete the registration. Please have the following available:
Tax information (Social or Tax ID) & Sponsor information.

Driver Information


Agree to SMS
Get lineup text messages

Emergency Contact

Information is only shared with EMT staff.
  1. 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
  2. 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
Divisions Select all divisions that apply
All Options
Bandit
Bandoleros
Hobby Stock
International
Late Model
Legends
Sportsman
6 Shooters
SelectName Select all that applyQtyPrice
Additional Adult Ticket
$30.00
Banquet Adult Ticket
1
$30.00
Kids Under 12 Ticket
$15.00
Line Total$0.00
Processing Fee$0.00
Total$0.00

Media

Just some information for the announcer

Car Information

Crew Information

Consent to follow the rules.


I agree to all rules and terms of the Jefferson Speedway.
Processing Fee: $0.00
Total: $0.00
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