East Coast Gassers

     MEMBERSHIP APPLICATION
NAME: DATE:
STREET ADDRESS:
CITY                                                            |STATE: ZIP:
EMAIL:
PHONE: AGE:
   
CAR INFO:
MAKE: MODEL: YEAR:
ENGINE:
E.T. RANGE:

PLEASE ATTACH A PICTURE OF YOUR CAR; OR EMAIL IT TO US!
 

Yearly Dues are $30 US; or $35 for Canadian residents.

 

If you plan on racing with our club; there is a one-time competition fee of $45; which is due along with your yearly membership dues.

 

MEMBERS RECEIVE:
Club Decal
Membership Card
Monthly Newsletter with race results and pictures.

Print this form and mail it with your check payable to the East Coast Gassers
Mail to:
East Coast Gassers
25 Den Road
New Hartford, CT. 06057

Or, Click Here to Open Word doc to Print

BACK