56th I-500 Qualifying Registration

1
Please verify that you are human* This field is required.
2
Team Name* This field is required.
3
Team Owner* This field is required.
First Name
Last Name
4
Team Owner Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
United States
Canada
United States
Country
5
Team Owner Email* This field is required.
example@example.com
Confirm Email
6
Team Owner Phone* This field is required.
Please enter a valid phone number.
7
Sled Number* This field is required.
8
Alternate Sled Number* This field is required.
9
Sled Year & Make* This field is required.
10
Sled Model* This field is required.
11
Motor Make* This field is required.
12
Motor Serial Number
13
Sponsors* This field is required.
Huge
Large
Normal
Small
Ok
Ok
14
Event SelectionSelect all of the Events that your team will be participating in. Make sure you select all races.
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ORDER SUMMARY
Total costUSD
I-500 QualifyingEnter description
$650.00Edit
Back
1
1
Quantity
I-500 Optional Practice
$200.00Edit
Back
Total cost $0.00
Credit Card
First Name
Last Name
Credit Card Number
Security Code
January
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September
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Expiration Month
2024
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
Expiration Year
Billing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
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Hungary
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India
Indonesia
Iran
Iraq
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Israel
Italy
Jamaica
Japan
Jersey
Jordan
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Kenya
Kiribati
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Laos
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Liberia
Libya
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Lithuania
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Mali
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Mayotte
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Poland
Portugal
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Rwanda
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Western Sahara
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Other
Country
15
How many Riders does your team have?* This field is required.This cannot be changed later, make sure all drivers are registered at this point.
Two (2)
Three (3)
Four (4)
16
1st Rider* This field is required.
First Name
Last Name
17
1st Rider Email Address* This field is required.
example@example.com
Confirm Email
18
1st Rider Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
United States
United States
Canada
Country
19
1st Rider Phone Number* This field is required.
Please enter a valid phone number.
20
1st Rider Date of Birth* This field is required.MM-DD-YYYY
Date
Month
Day
Year
21
1st Rider Rookie* This field is required.
YESNO
22
1st Rider ResumeAccomplishments & Riding History
Huge
Large
Normal
Small
Ok
Ok
23
2nd Rider
First Name
Last Name
24
2nd Rider Email Address
example@example.com
Confirm Email
25
2nd Rider Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
United States
United States
Canada
Country
26
2nd Rider Phone Number
Please enter a valid phone number.
27
2nd Rider Date of BirthMM-DD-YYYY
Date
Year
Month
Day
28
2nd Rider Rookie
YESNO
29
2nd Rider ResumeAccomplishments & Riding History
Huge
Large
Normal
Small
Ok
Ok
30
3rd Rider
First Name
Last Name
31
3rd Rider Email Address
example@example.com
Confirm Email
32
3rd Rider Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
United States
United States
Canada
Country
33
3rd Rider Phone Number
Please enter a valid phone number.
34
3rd Rider Date of BirthMM-DD-YYYY
Date
Year
Month
Day
35
3rd Rider Rookie
YESNO
36
3rd Rider ResumeAccomplishments & Riding History
Huge
Large
Normal
Small
Ok
Ok
37
4th Rider
First Name
Last Name
38
4th Rider Email Address
example@example.com
Confirm Email
39
4th Rider Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
United States
United States
Canada
Country
40
4th Rider Phone Number
Please enter a valid phone number.
41
4th Rider Date of BirthMM-DD-YYYY
Date
Year
Month
Day
42
4th Rider Rookie
YESNO
43
4th Rider ResumeAccomplishments & Riding History
Huge
Large
Normal
Small
Ok
Ok
Should be Empty: