Track Day Registration McLNB .pdf

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Original filename: Track Day Registration McLNB.pdf
Title: TrackDay_Registration_SD_6_14

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FONTANA TRACI< DAY

Fontana Autoclub Speedway I Thursday October 26th 2017 I 9:00am - 5:00pm

REGISTRATION FORM
To reserve your spot for the Fontana Track Day, participation fee must be paid in full. Space is
limited, registrations will be taken on a first come first served basis.
Please fill in the Registration Form and send it back by email: Events@McLarenNB.com.

REGISTRATION

FIRST NAME

LAST NAME

GUEST FIRST NAME

GUEST LAST NAME

EMAIL

CELL

EMERGENCY CONTACT NAME
EMERGENCY CONTACT NUMBER
VEHICLE YEAR

I

MAKE

TRACK EXPERIENCE (CHECK ONE)

0BEGINNER

I

MODEL

D INTERMEDIATE D EXPERT

Regular Track Day Fee: $699 per participating car
Helmet Rental: $20 Each
0 1 helmet
O 2 helmets
CARDHOLDER NAME

Guest Fee: $30 per person

CC AUTHORIZATION FORM

BILLING ADDRESS
Cl1Y
CREDIT CARD 1YPE

Ov1sA

CREDT CARD NUMBER
CARD IDENTIFICATION NUMBER

-

0AmEx

-

I

I

STATE

0 MasterCard
-

I

ZIP

EXP. DATE

(3 DIGITS ON BACK OF CARD/ 4 DIGITS ON FRONTOFAmEx)

I hereby authorize McLaren Newport Beach to charge my card in the amount of $
for the Fontana Track Day Experience.
DATE:

SIGNATURE:

,AlcLare´┐Ż
NEWPORT BEACH


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