REQUIRED INFORMATION FOR THE IRS 1099 FORMS

VISITORS: IF YOU ARE THE DRIVER

This form must be filled out completely if your car is not registered with B.M.M.R.C in order to receive any money.  

CAR # 

CLASS  CAR OWNER

DRIVERS NAME     

SOCIAL SECURITY NUMBER             

STREET ADDRESS       

CITY     

STATE 

ZIP                                

PHONE NUMBER              
DATE OF BIRTH 

I do hereby agree to abide by all By-Laws, Rules, Regulations, and such decisions of the Officials and Board of Directors that may affect my conduct  and activity, both on and off the track.

    ______________________________________________                     ___________________

                                     Signature                                                                    Date

I do hereby certify that                 I am         I am not

currently under any medical treatment which may impair my ability to compete as a driver in regular Micro-Sprint competition events

______________________________________________                     ___________________

                                     Signature                                                                    Date