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OFFICIAL ENTRY FORM USRA STOCKS & X MODS

25th ANNUAL MENDOZA LAW FIRM FALL NATIONALS – VADO SPEEDWAY PARK, VADO, N.M. OCT 17-19, 2025

Official Entry Form USRA Stock & X Mods
Driver Name
Driver Name
First
Last
Car Class
Address
Address
City
State/Province
Zip/Postal
Country

If driver & owner information is the same, Owner section need not be filled out. IRS Form 1099 will be mailed to Owner.

Driver Name
Driver Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Country

Make checks payable to VADO SPEEDWAY PARK and mail to 3590 W PICACHO AVE, LAS CRUCES NM 88007-4725.

For credit card purchases, please complete the following

(3 DIGIT NUMBER ON BACK OF CARD)