USRA DESERT & MOTOCROSS ENTRY FORM

USRA DESERT & MOTOCROSS ENTRY FORM
RIDERS NAME

First NameLast Name
AGE
BIRTHDATE

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
BIKE BRAND
CC
BIKE/USRA #
SATURDAY DESERT CLASSES
SUNDAY MOTOCROSS CLASSES
SUNDAY MOTOCROSS CLASSES
WOULD YOU LIKE TO ADD ANOTHER RACER? IF SO, HOW MANY?

RIDER 2

First NameLast Name
AGE
BIRTHDAY

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
BIKE BRAND
CC
BIKE/USRA #
SATURDAY DESERT CLASSES
SUNDAY MOTOCROSS CLASSES
SUNDAY MOTOCROSS CLASSES
ADD A SECOND CLASS FOR MOTOCROSS HERE

RIDER 3

First NameLast Name
AGE
BIRTHDAY

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
BIKE BRAND
CC
BIKE/USRA #
SATURDAY DESERT CLASSES
SUNDAY MOTOCROSS CLASSES
SUNDAY MOTOCROSS CLASSES
ADD A SECOND CLASS FOR MOTOCROSS HERE

RIDER 4

First NameLast Name
AGE
BIRTHDAY

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
BIKE BRAND
CC
BIKE/USRA #
SATURDAY DESERT CLASSES
SUNDAY MOTOCROSS CLASSES
SUNDAY MOTOCROSS CLASSES
ADD A SECOND CLASS FOR MOTOCROSS HERE

SPONSERS
Signature

PAY YOUR ENTRY FEES HERE. PLEASE CHOOSE ALL THE QUANTITIES & CLASSES AND YOU ARE RACING. ALL PRE ENTRY DISCOUNTS HAVE BEEN APPLIED TO PRICING.

SATURDAY DESERT BIG BIKE PRO

PLEASE SELECT THE NUMBER OF CLASSSES YOU'RE RACING

$120.00 Quantity

SATURDAY DESERT BIG BIKE EX/AM/NOV

PLEASE SELECT THE NUMBER OF CLASSSES YOU'RE RACING

$50.00 Quantity

SATURDAY DESERTTEAM

PLEASE SELECT THE NUMBER OF CLASSSES YOU'RE RACING

$70.00 Quantity

SATURDAY DESERT MINI EX/AM/NOV

PLEASE SELECT THE NUMBER OF CLASSSES YOU'RE RACING

$45.00 Quantity

SATURDAY DESERT MINI 65 A & B

PLEASE SELECT THE NUMBER OF CLASSSES YOU'RE RACING

$45.00 Quantity

SATURDAY DESERT PEEWEE A

PLEASE SELECT THE NUMBER OF CLASSSES YOU'RE RACING

$30.00 Quantity

SATURDAY DESERT PEE WEE B

PLEASE SELECT THE NUMBER OF CLASSSES YOU'RE RACING

$25.00 Quantity

Sight lap Friday night

Sight lap Friday at 6pm

$10.00 Quantity

SUNDAY MOTOCROSS

PLEASE SELECT THE NUMBER OF CLASSES YOU'RE RACING

$30.00

Total

Credit Card

Should be Empty: