SOUTHERN OUTLAW SPRINTERS Mike Miller, William Webb; Owners 850-287-5689 6143 Walton St. Pensacola, FL. 32503 SOSoutlaws.com Office; 850-474-1706 Fax; 850-542-7553 [email protected] The 2013 early membership fee is $ 125.00. Membership will include a member accident policy. Early membership deadline is March 1, 2013. After March 1st membership is $ 150.00 YOU MUST BE A MEMBER TO RECEIVE SOS POINTS & SOS MONETARY AWARDS Driver __________________________________________________ Car # _______________ Address _____________________________________________________________________ Phone: _________________________ Email: _______________________________________ S.S. or Fed ID # ___________________________________ Amount Enclosed: _____________ Unless otherwise indicated the 1099 tax form of SOS award monies earned, will go to the driver. If the tax form should not go to the driver, please indicate in the area below. Car Owner: _______________________________ Phone: ____________________________ Address: _______________________________ Cell: ____________________________ _______________________________ Email: _____________________________ S.S. or Fed ID # ____________________________ ______________________________ Recipient’s Signature I agree to abide by all of the SOS rules & regulations. I agree to behave in a reasonable, professional, and responsible manner at all times, during SOS events. I understand that my membership and standing in the SOS may be revoked for unreasonable or unsportsmanlike conduct/behavior. I also may be fined/penalized for any unreasonable or unsportsmanlike conduct. Drivers Signature: ___________________________________ Date: ____________________ Return To: Southern Outlaw Sprinters SOSoutlaws.com 6143 Walton St. Pensacola, FL. 32503
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