tier 3 | Laps Incorporated

Tier 3 Membership
Single day events at Autobahn Country Club at $300.00 each or Road America Weekend at $400.00 (before 6-1-12)
Fill out the form below and submit your application.

If you have any questions about the application or the Membership Tiers shoot us an email at info@lapsincorporated or give us a call at 630.205.0055

First Name*

Middle Name

Last Name*

Address*

Apartment Number

City*

State*

Zip*

Phone*

Work Phone

Fax

Email*

Date of Birth* (00/00/0000)

Emergency Contact

Emergency Contact Phone Number

Track Car Make

Track Car Model

Track Car Year

Your Experience (driving school / lapping days)

Drivers License Number

Auto Insurance Company

Auto Insurance Policy Number

Auto Insurance Expiration Date

Once you submit your application, One of our chief driving enthusiast will then review your application and contact you as soon as possible. Once your application is approved we will then send you a Username and Password so you can Login and start registering for Track Days.