NW SUPERMINICUP ASSOCIATION MEMBERSHIP FORM 2008         Drivers Name: _____________________________________________________   Address: _________________________________________________________   City: _________________ State: _______________ Zip: __________________   Age: _____________ Birth Date: ____________________________________   Social Security: _____________________________   Phone: (   ) ______- _________ Cell: (   ) ______- ______   Division:       Future Stars: __________________     Car #              1st Choice_______________2nd Choice ____________________     (Car numbers will be given on a first come first serve basis if number is available)   Fee Schedule Per Driver                                                                                                                                                                Family Pass (drivers 8-15)  Includes one driver and one parent/guardian)  $70.00   Additional members:                                              $25.00        Driver _____________________________________________        $______________   Parent/Guardian______________________________________       $ ______________                                                                                  Additional member__________________________________                $_______________              Additional member__________________________________                $_______________                                                                                              Total amount paid $ _______________