Membership Application | Challenge Cup Series

To join Challenge Cup Series, please fill out and submit the form below. Payment instructions will be emailed to you once we receive your application – or – you may download a printable application.

Member Information
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone*
Mobile Phone*
Email*
Occupation*
Emergency Contacts
Primary Contact Name*
First Last
Primary Contact Phone*
Secondary Contact Name*
First Last
Secondary Contact Phone*
Competition License
SCCA/CASC Membership #*
Competition License Expiration Date*
Series Car Information
Make*
Model*
Transponder*
Preferred Car Number*
Secondary Car Number*

Sponsors

Add additional sponsors by clicking the plus sign at the end of the row.

Sponsor	Website

Website Bio
The following information is for usage on the Challenge Cup Series website Driver Profile section.
Permission to display bio on website?*
- Yes, please add my bio to the website.
- No, I do not want my bio on the website.
FV Make / Model
Hometown
Years Racing FV
Top 2 Favorite Track
Favorite Modern Driver
Why FV Class?
Photo(s)
If you wish to have a profile picture (head shot) and/or car picture on your driver profile, please attach it here.
Drop files here or

Accepted file types: jpg, gif, png.
Membership
Full Membership includes participation in the race series events if registered including all contingencies, full voting privileges, etc. - $150.00 USD or $200.00 CAD. Payment may be made via mail or at the track.
Type of Membership*
- New Member
- Renewal
Payment*
- I will mail my check.
- I will pay at the track.
Agreement*
I have read and agree to follow the 2019 CCS General Competition Rules, Regulations, and Technical Specifications.
Printed*
Please type your full name.
Signature*
Email
This field is for validation purposes and should be left unchanged.

Member Information

Emergency Contacts

Competition License

Series Car Information

Website Bio

Membership