"The Best Vintage Car Racing in the Midwest" A Fast Blast from the Past!
22711 NW Pink Hill Rd, Blue Springs, Missouri 64015, United States
2023 Membership Application
2023 SMVR MEMBERSHIP APPLICATION FORM
(Please Print Legibly, Thank You)
Name – ________________________ Date / /
Spouse Name – __________________
Street – ___________________________________________________
City/State/Zip Code - ________________________________________
Cell Phone # - (_____)______-____________
Email – ____________________________________________________
Car Year - _________ Make - ___________ Model- ________________
Requested Car # - ________ (Existing/Active SMVR Member Numbers are Grandfathered and you may have to add a Letter if the number your requesting currently exists)
Car Color - ____________ Engine Make & Size - ________/_______
Please list 2 Sponsors (Not required) - ______________________________/__________________________
SMVR MEMBER DUES ARE $35.00 PER YEAR
· Paid member will be able to race at all S.M.V.R. sponsored events, attend and vote at meetings.
Dues must be paid before member can race!
No pay, no play!
Make checks payable to: SMVR
Mail to: Dan Schmidt
22711 NW PINK HILL ROAD - BLUE SPRINGS, MO 64015
I, THE UNDERSIGNED, HEREBY RELEASE AND HOLD HARMLESS THE OFFICERS AND MEMBERSHIP OF THE JOSLINS JEWELRY SHOW ME VINTAGE RACING SERIES OF ANY AND ALL RESPONSIBILITY FOR ANY DAMAGES OR INJURIES THAT I, THE OWNER AND/OR THE DRIVER OF MY RACE CAR MAY SUSTAIN AT ANY S.M.V.R. EVENT.
_____________________________________________
Signature – Car Owner or Driver Only
