3/7/2026 CPLMS Event Registration Form For Hickory Motor Speedway

CPLMS Event Registration Form
Track: Hickory Motor Speedway
Event Date: March 7, 2026
Event: CPLMS only
Location: 3130 Hwy 70 SE, Newton, NC
Acknowledgment and Agreement
The Driver and Car Owner, individually and collectively, acknowledge that they have read, understand, and agree to comply with all terms and conditions set forth in the 2026 CPLMS/CCMS Rule Book, including all amendments, bulletins, and supplemental regulations.

By submitting this form, the Driver and Car Owner agree to abide by all CPLMS/CCMS rules, procedures, and official decisions.

This entry form is valid for ONE (1) CPLMS/CCMS scheduled event only.

Important Payment Notice
CPLMS/CCMS must have a completed W-9 on file for the 2026 season in order for any competitor to receive purse payments.

Series Contact Information
Carolina Pro Late Model Series
Carolina Crate Modified Series
3579 Wilkesboro Hwy
Statesville, NC 28625

📞 Phone: 850-791-1092
✉️ Email: carolinaprolatemodelseries@gmail.com
Please fill out the form below to register for the event:

OFFICIAL ENTRY FORM & COMPETITOR AGREEMENT
By submitting this entry form, the Car Owner and Driver acknowledge that they have read, understand, and agree to comply with the 2026 CPLMS/CCMS Rules and Regulations, including all technical bulletins, amendments, supplemental regulations, and official interpretations.

Participation in any CPLMS/CCMS event constitutes acceptance of all rules and decisions made by CPLMS/CCMS officials.

ENTRY CONDITIONS
Entry fee is non-refundable
Entry does not guarantee a starting position
Submit entry only if you intend to compete
CPLMS/CCMS reserves the right to refuse entry to any car or person at any time

DECALS & SERIES IDENTIFICATION
All entered race cars must properly display CPLMS/CCMS, series sponsor, and contingency decals at all events, in accordance with the current Rule Book and official decal placement diagram. Failure to comply may result in penalties, loss of points, loss of winnings, or disqualification.

MEDIA, PROMOTIONAL & SERIES RIGHTS
The Car Owner and Driver grant CPLMS/CCMS, its partners, sponsors, broadcasters, and hosting facilities the worldwide, non-exclusive, royalty-free right to use their names, likenesses, images, race car appearance, uniforms, video (including in-car), photographs, statistics, performance data, and related content for broadcast, streaming, promotional, marketing, social media, and commercial purposes, without compensation or approval.

ASSUMPTION OF RISK & LIABILITY
Car Owners, Drivers, and team members acknowledge that auto racing is inherently dangerous and agree to participate at their own risk.

No express or implied warranty of safety shall result from the publication of or compliance with CPLMS/CCMS rules. CPLMS/CCMS assumes no responsibility for injury, death, or property damage.

The Car Owner is responsible for ensuring that all drivers, crew members, and representatives execute the required Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement, as required by CPLMS/CCMS, its insurer, and the hosting facility.

RULE INTERPRETATION & ENFORCEMENT
All interpretations and decisions by CPLMS/CCMS officials are final, non-appealable, and non-litigable
CPLMS/CCMS reserves the right to modify, amend, or enforce rules at any time
Ignorance of the rules will not be accepted as an excuse
Any matter not specifically covered by the Rule Book will be handled at the discretion of CPLMS/CCMS officials

LEGAL GOVERNANCE
This agreement shall be governed by the laws of the State of North Carolina.
All parties waive the right to trial by jury where permitted by law.
Any legal action shall be brought exclusively in North Carolina state or federal courts, unless CPLMS/CCMS elects otherwise.

ELECTRONIC SIGNATURE & CERTIFICATION
By submitting this entry form, the Car Owner and Driver certify that:

All information submitted is accurate
They meet all eligibility requirements
They agree to be bound by the 2026 CPLMS/CCMS Rules and Regulations
Submission constitutes their electronic signature
Additional terms, conditions, and supplemental regulations may apply.
Driver Information
Driver's Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Car Details
Number*
Team Name
Would you like your team name listed?
Parking Details*
What are the dimensions of the truck and trailer you will be bringing?
Point of Contact

At track point of contact for updates on raceday information.
Name

First NameLast Name
Phone Number

Area CodePhone Number
Sponsor Information
Primary Sponsor
Cosponsors
Payout information

Where do you want your payout to go?
Have you submitted 2025 taxpayer information?*
Without this information payout will not be sent.
Check Payable to
Taxpayer Identification Number
SS# or EIN#
Fill in the number above
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
W-9

Browse Files
Available for download on carolinalatemodels.com if needed Cancelof
Registration Payment
My Products*
prevnext( X )
CPLMS event entry$75.00
Paid on or before 2/28/2026

CPLMS event entry$100.00
Paid 3/1/2026 - 3/6/2026

CPLMS event entry $125.00
Paid on 3/7/2026

Subtotal $0.00Tax $0.00Total $0.00
Release & Agreement
Required Agreement*

Team Owner/Driver hereby agrees to the TERMS AND CONDITIONS listed above.
Required Agreement*

Team Owner/Driver agrees to comply with all rules and regulations as required and stated in the 2025 CPLMS/CCMS rulebook.
Driver's Signature*

Clear
Date Signed*

MonthDayYear
Date
By signing above, Driver and Car Owner agree they have read, and will abide by all Carolina Pro Late Model Series (CPLMS) and Carolina Crate Modified Series (CCMS) rules and decisions, as well as the stipulations in the entry blanks. Entry may be rejected if all information and signatures are not provided.

Proof of age and parental custody is required. The release may only be signed by the custodial parent or legal guardian. Drivers under 15 years of age must have prior approval from CPLMS/CCMS to compete.

Contact Keith Graham at (850)791-1236 with any tech questions.
Contact Wendi Graham at (850)791-1092 with any administration questions.
Should be Empty:

CPLMS Event Registration Form

Driver Information

Car Details

Point of Contact

Sponsor Information

Payout information

Registration Payment

Release & Agreement