2010 Membership Application

Please complete the following application. Enclose a check for $35 payable to the American Racing Mower Association and mail to 308 Schucks Road, Bel Air, MD. 21015

Personal Information:

Name: ____________________________________________________

Date of Birth: __________ Date of Application: ___________________

Address: __________________________________(No P.O. Boxes)

City ____________________ State: ________ Zip Code: ____________

Work Phone #: _____________________

Home Phone #: _____________________

Email address: _____________________

Shirt size: ________

Emergency Contact: _____________________

Phone #: _____________________________

Relation: _______________ Personal Physician: ___________________

Physician Phone #: ______________________

Allergies: ______________________ Blood Type: _________

Special Conditions: __________________________________________

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Racing Classes: _____________________________________________

Mower Model(s): ____________________________________________

Which club do you race with? __Moose Mountain Speedway Hastings, NY 13076________________________________