2026 URA License Application

Home Track Selection
License Information
Licensee Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Information
Emergency Contact Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Licensee
Mother, Father, Spouse, etc.
Releases & Agreements
Click on the links below to read the full releases & agreements.

ASSUMPTION OF RISK & INDEMNITY AGREEMENT

ADDITIONAL RULES & RELEASES
Release Agreements - Please select to agree to terms.
Licensee Signature for Releases & Agreements
Date Signed

MonthDayYear
Date

LMSC Driver License

$150.00

Driver License

All Other Divisions

$100.00

Crew Member

All Crew Members

$75.00

Total

Credit Card

Apple Pay

Google Pay

Cash App Pay

ACH Bank Transfer

License Information