North Carolina Center for Automotive Research - Registration
210 Technology Drive. Garysburg, NC 27831
Name
*
First Name
Last Name
Email
*
example@example.com
Car Make and Model
*
Car Coupe or Convertible
*
Coupe
Convertible
Track Driving Experience Level
*
New, First Time
Driven NCCAR Once or Twice Before
Driven a Few Race Track Driver Education Events
Experienced Track Driver and or Driving Instructor
Submission Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Waiver of Liability
Track Event Rules
I have read and accept terms and conditions of the Waiver of Liability
*
PAY FOR PARTICIPATION
*
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next
( X )
Each Car on Track
$200.00
$
200.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
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