2025 Midwest Jr Super Series Points Registration Form

    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 2023 season:

    INDEX:
    7.908.9011.9013.90

    AGE GROUP:
    13-UP10-126-95 (single pass only)

    CLASSES:
    PRO SPORTSMANSPORTSMANOUTLAW 330QUICK 16

    JACKET SIZE:

    *I agree to abide by the rules and regulations of the Midwest Junior Super Seriesyes