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255981098624514

USAT Member Registration

Racer Information – Select a Category – Payment – Confirmation

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MESSAGE
USAT Membership Number:
Email Address:
First Name:
Last Name:
Address 1:
Address 2:
City/State:
Zip Code
Phone:
Date of Birth:
Gender:
Emergency Contact Name:
Emergency Contact Phone:
Select your start time:
I understand my application is pending the verification of my USAT license status and that the first night that I race I will be required to sign a USAC waiver. I understand that if I do not race that I forfeit all fees.