WOODFORD GLEN APPLICATION FOR NEW MEMBERS 2025/2026

WOODFORD GLEN SPEEDWAY ASSOCIATION, INC.APPLICATION FORM FOR NEW MEMBERS 2025/2026
I am:*

Here to apply for a NEW membership

Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile*

Area CodePhone Number
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
Membership Type*

DriverNon-Driver
Occupation:*
Class*
Preferred Racing Number:*
Preferred
Emergency Contact Name*
Emergency Contact Email*
example@example.com
Emergency Contact Mobile*
Please enter a valid phone number.

Nominator Details
The Club Member that has Nominated me*

First NameLast Name
Nominated Members email*
Membership Level*

AdultYouth

Youth Membership Specifics

Membership:	$185.00
Pit Maintenance Fee:	$15.00
Total to pay:	$200.00

Youth Member Signature

Clear
Parent/Guardian Signature

Clear
THERE IS A STANDARD THREE-WEEK APPROVAL PERIOD FOR ALL NEW MEMBERSHIP APPLICATIONS FROM THE DATE
YOUR APPLICATION IS RECEIVED AND PAID FOR

Adult Membership Specifics

Membership:	$285.00
Pit Maintenance Fee:	$15.00
Total to pay:	$300.00

Bank Account for Prize Money*
Please enter a valid bank account number.
Adult Member Signature

Clear
THERE IS A STANDARD THREE-WEEK APPROVAL PERIOD FOR ALL NEW MEMBERSHIP APPLICATIONS FROM THE DATE
YOUR APPLICATION IS RECEIVED AND PAID FOR

I have*

As a new member filled in the application
Should be Empty: