Name:______________________________________________________

Address:____________________________________________________

City:_______________________ State:______ Zip:________________

Phone:_____________________ Email:_________________________

Type of Race car,class & # :__________________________________

Dues are $25 a year, which include 2 stickers, & monthly emails and/or mail outs.

Paypal fees to sevwa@sevwa.com (please add 2.5% of total to cover paypal service fees) subject:

Please make checks payable to K & L Motorsports and send to: 450 Oak Trace Rd, Hahira, GA 31632

Kathy Jaocbs 919-616-2183 Or Keith Bumgarner 919-616-1039 bumsride@sevwa.com