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2024 Bill Werner AMA Fast Brain Award Application
Contact Information
AMA Member Number*
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Check all classes you are competing in:*

50cc Production Chain Drive Sr. (4-8)50cc Production Chain Drive Shifter (4-8)50cc Production PW Shaft Drive (4-8)65cc Production (7-11)65cc Modified (7-11)85cc Modified (9-11)85cc Production (9-13)85cc Modified (9-13)85cc Modified Supermini (12-15)250cc Production250cc Modified450cc Production450cc Modified250cc-Open Singles (12+)Open HeavyweightWomen 122cc and Up (12+)
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Certification
I agree that the above information may be used for media purposes pertaining to the 2024 Mission Foods AMA Flat Track Grand Championship in Du Quoin, Ill. on June 30-July 5, 2024.*

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To be eligible for the 2024 Fast Brain Award, you must complete and submit this form no later than June 9, 2024.

SUBMISSIONS/INQUIRIES: Ken Saillant - ksaillant@ama-cycle.org - (614) 856-1900, ext. 1260
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2024 Bill Werner AMA Fast Brain Award Application