Lady Luck Speedway 2010 Registration Form
(use the PRINT icon up to the right. It will print with black text)

Registration Fee $10.00 

Please Print Legibly

Driver:

Home Phone: (______)__________________ Work Phone: (______)____________________

E-mail Address: ________________________________              

Owner: (If same as driver just mark "Same")

SSN/Fed ID: ________________________ Date of Birth: ________/_______/_______

Name /Company Name: ________________________________________________________

Address: ______________________________City, State, Zip: _____________________________

Home Phone: (______) _______________
Work Phone: (______) _______________                                            

Classification of Car: (circle one)

Car #:  1st Choice ____________ 2nd Choice  _____________ 3rd Choice  _____________

If you are a rookie in your class & would like to be in the running for ROOKIE OF THE YEAR please mark below.
(To be eligible, you must HAVE NOT RACED 5 OR MORE RACES in ANY previous year)

YES___________         NO____________

Sponsors:

Main Sponsor to be listed in program: ____________________________________

Other sponsors: ______________________________________________________________

I will abide by the rules of Lady Luck Speedway as listed in the 2010 rulebook for this season.  I will not hold
Lady Luck Speedway, its owners, or any officials responsible for any physical injury or damage to my vehicle(s).
I understand a breathalyzer test may be required at any time.  I understand refusal to take the test or failure
of the breathalyzer test will result in disqualification with no pay or points. 

 

Signed: _______________________________  Date:_________________________________
                       (Participant) 

Signed: _______________________________  Date:_________________________________                        
                      (Track owner) 

   

Mail To:
                3408-Ave Q
                Lubbock, Texas 79412
                ATTN: Patsy Williams

If you do mail  your registration, PLEASE give Patsy a call 2 or 3 days later @ 789-6557 to make sure she got it and everything is set.

You can also drop it off by her work located at 3408-Ave Q, Monday - Friday from 9am to 5pm.