BROCKVILLE ONTARIO SPEEDWAY
GO-KART, REGISTRATION

DIVISION:____________________ KART #_______________

DRIVER’S NAME:_________________________ CAR OWNER:____________________

AGE:_______ DOB_______day_______month_______year

MAILING ADDRESS:Street_______________________ PHONE: (H)__________________
Town________________________ (W)__________________
Postal Code_______________________

E-MAIL:____________________________Team Website_____________________________

Marital Status:____________________________Children:____________________________

Occupation:_____________________________ Home Track:________________________

Started Racing:_____________________Feature Wins this Division:____________________
Divisions Raced:____________________Championships to Credit:_____________________

Awards:______________________________________________________________________

Main Sponsors:_______________________________________________________________ ________________________________________________________________
________________________________________________________________
________________________________________________________________

Chassis:_________________________________Engine Builder:________________________

Pit Crew:______________________________ _______________________________
_______________________________ _______________________________

PLEASE PRINT ALL THE ABOVE INFORMATION, THANK YOU!
Please mail completed driver profile/registration sheet to: or fax (613)348-1562
Brockville Ontario Speedway, RR#1, Brockville Ont. K6V 5T1 asap so we can update our records and program for the upcoming season, driver registration fee may apply to those who do not pre-register.***Return this form promptly to insure driver and sponsor promotion!***