2018 Midwest Jr Super Series Points Registration Form

*The deadline to register for 2018 MJSS points is May 25th, 2018.

Participant Name:
Address:
City:
State
Zip Code
Email Address:
Birth Date:
Parent/Guardian Name:
City:
State
Zip Code

Emergency Contact

Name:
Phone:

CAR NUMBER:
NHRA MEMBER NO:
Ex. Date:

*Please Check the following classes you expect to participate in for the 2016 season:

INDEX:
7.908.9011.9013.90
AGE GROUP:
13-UP10-126-95 (single pass only)
CLASSES:
PRO SPORTSMAN APRO SPORTSMAN BSPORTSMANOUTLAW 330QUICK 16
JACKET SIZE:
*I agree to abide by the rules and regulations of the Midwest Junior Super Seriesyes