Midwest Indoor Championship Sign Up - Pay at Event

Complete the form below if you wish to sign Up for the MIC and pay the entry fee at the event.
If you wish to pay in advance complete this signup form.

Please one form per racer, Thank You

MIC Sign Up - Pay At Event

Name*
First Last
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
1st Class*
1st Transponder #*
Register 2nd Class?*
- No
- Yes
2nd Class*
2nd Transponder #*
Register 3rd Class?*
- No
- Yes
3rd Class*
3rd Transponder #*
Register 4th Class?*
- No
- Yes
4th Class*
4th Transponder #*
Price: 1 Class
Price:
Price: 2 Classes
Price:
Price: 3 Classes
Price:
Price: 4 Classes
Price:
Amount Due at Event:
$0.00
Can we email you in the future?*
- Yes
- No
Comments
This field is for validation purposes and should be left unchanged.

Midwest Indoor Championship Sign Up – Pay at Event

MIC Sign Up - Pay At Event

Genesis RC Raceway