IMCA Membership Application

IMCA MEMBERSHIP APPLICATION
NOTE: All licenses purchased before December 15, 2025 will be for the 2025 racing season.

If you need to purchase your 2026 license, please do so after December 15, 2025.

All licenses purchased after December 15, 2025 will be processed for the 2026 season.
Today's Date*

MonthDayYear
Date
New or Renewal Application*

RenewalNew Member
Division*

Modified $130Late Model $115Sprint Car $120Stock Car $110Northern SportMod $105Southern SportMod $105Hobby Stock $100Sport Compact $75Mod Lite $75Associate/Crew Member $75
Driver's Name*

First NameLast Name
Gender*

MaleFemale
Member ID Number (5 digit number on license, if previous member)
Spouse Name

First NameLast Name
Driver's Birth Date*

MonthDayYear
Age
Minor Application Fee (ages 14-17)*
Age in Days
Address*

Street Address

Address 2/PO Box

CityState / Province

Postal / Zip Code
Primary Phone Number*
Secondary Phone Number
E-mail (required)*

Confirmation Emailexample@example.com
Car #*
Rookie

YesNo
Do you need a decal packet?*

YESNO
Jacket Size*

SmallMediumLargeXL2XL3XL4XL5XL6XL
Will you be running a crate motor?*

YESNO
Rookie status must be declared by July 1. All drivers must send photo of car with required decals to cbgramm@imca.com to be eligible for contingencies and point fund.
IMCA membership for 2025 includes a $100,000 excess medical insurance policy ($5,000 deductible) which covers you at any IMCA sanctioned event. This excess medical coverage goes into effect after the $5,000 deductible has been met, per the terms and conditions of the policy, as a result of an IMCA sanctioned racing accident, up to $100,000. This excess medical coverage is over the track insurance and any other valid and collectible insurance that you, the IMCA member, may have. A $10,000 accidental death, dismemberment and paralysis policy is also included for IMCA sanctioned events, or for travel to or from IMCA sanctioned events. The policy period is from 1/1/25 to 12/31/25.
Signature*

Clear
Total

Payment Processing*

USDOnline Membership with $5.95 Card Processing Fee

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

IMCA MEMBERSHIP APPLICATION