GULF OAKS SPEEDWAY

 

 

Please make checks payable to Gulf Oaks Speedway

20281 Longview Rd., Long Beach, MS. 39560

 

____ New Member                                      ____Renewing Member

 

 

$50.00        1 Year Master membership which includes discounts on entry fees, personel key for access to           

                   Gulf Oaks Speedway for unlimited practice.

 

$10.00        For each associate member (for each additional family member after one member has paid for a

                   master membership.

 

WKA membership # if available________________________

 

Master members name ___________________________________________________________________

 

Address _______________________________________________________________________________

 

City _____________________________ State ____________________________ Zip code ____________

 

Phone number _______________________ Email address _______________________________________

 

Associate Members

 

Name_________________________ Age________    Name __________________________ Age_______

 

Name _________________________ Age _______    Name __________________________ Age_______

 

Name _________________________ Age _______    Name __________________________ Age _______

 

Name _________________________ Age _______    Name __________________________ Age _______

 

DATE ________________ Guardian Signature _______________________________________________