Membership Application

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SMVR

2020 MEMBERSHIP APPLICATION

Name ___________________________________________________ Date ______

Spouse Name _______________________________________________________

Street _____________________________________________________________

City ______________________________State ____________ Zip _____________

Phone # ____________________________________________________________

Email ______________________________________________________________

Car Year___________ Make ___________________ Model __________________

Car # ____________ Car Color _________________ Engine __________________

My car is: Restored__________ Replica __________ Newly Built ______________

SMVR DUES ARE $30.00 PER YEAR

Paid member will be able to race at all S.M.V.R. sponsored events, 

attend and vote at meetings and receive all club newsletters.
 

Dues must be paid before member can race! 

No pay no play!

Make checks payable to:
 

SMVR

Mail to: Mickey Fleehart

314 E. ORCHARD ST., ODESSA, MO 64076

I, THE UNDERSIGNED, HEREBY RELEASE AND HOLD HARMLESS THE OFFICERS AND MEMBERSHIP OF S.M.V.R. OF ANY AND ALL RESPONSIBILITY FOR ANY DAMAGES OR INJURIES I MAY SUSTAIN AT ANY S.M.V.R. EVENT.
 

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Signature