to 2015 Membership Application in MS Word file

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HPMA MEMBERSHIP APPLICATION - 2015
Name_______________________________ Birth Date ________________ Race No. __________(1st 3 choices)
Address____________________________ City ___________________ State _________ Zip __________
Phone/email _________________________Parent Name(if rider <18)_______________________________
VALID HPMA RIDER CLASSES:
50cc Expert – Competitive 50cc or less bikes, riders through age 9. Legal bikes:
WEB SITE: www.hpmainc.com – Forms available here
Polini X1, X3 Std. or Works, KTM Pro JR or SR, Beta, LEM, Cobra X3, CM50
King Cobra, Husky. All liquid cooled 50cc bikes or similar hp ratings. Riders in
this class not eligible for Mini Non-Comp or Pee-Wee.
Pee Wee A: 50 cc or less liquid and air cooled bikes up to 12” wheels. Pee wee A
riders eligible for 50 cc open but not eligible for 50 cc Expert. Riders from 4-9
years. No training wheels.
PeeWee B/C: Non-competitive, air cooled, recreational 50cc or less bikes only,
12mm carb, 10” wheels, stock bore and stroke. Riders age 4 through 9. Legal
bikes: Honda CRF50F (XR50R), Kawasaki KDX50, KTM Mini Adventurer,
Suzuki JR50, Yamaha PW50, Metrakit stock, KTM Sx Mini; No training wheels.
65 & 85 riders are illegal here.
50 Open: 50cc rider from 4-9 years old. Pee Wee A and 50cc Expert eligible.
50cc PEE WEE CLASS riders will not be eligible for any 65cc class.
Mini Non-Competitive: 110cc or less non-competitive, recreational, air cooled
mini bikes only. Riders age 6-12. Stock wheel sizes. Legal bikes: Beta Mini
Cross 10/10 & 12/15, Kawasaki KLX110, Honda CRF 70/80/100F (XR), Husky,
KTM JR & SR Adventurer, LEM LX2/3/4, Polini X1/3/5 recreational air cooled,
Suzuki JR (DS) 80/DRZ110, Yamaha PW80/TTR90, or any other comparable
bikes with similar hp ratings. 65 & 85 riders are illegal in this class.
65 A/B: 65cc two stroke or up to 110cc air cooled four stroke, wheel limit 14”
front and 12” rear. Riders age 6 through 11. Legal bikes: Kawasaki KX65 &
KLX110, Suzuki RM65 & DRZ110, Yamaha TTR90, Metrakit 65. Riders in this
class are not eligible for Mini Non-Comp.
65 Open: Riders from 6 through 11. Eligible riders are any 65cc riders following
same bike requirements for 65 A/B class.
85 A/B/C: 85cc two stroke or any recreational air cooled four stroke up to 150cc.
Wheel limits up to 19” front and 16” rear. Riders through age 16. Legal 4 stroke
bikes are air cooled CRF150F, TTR125, or other similar bikes. BIG WHEEL
STOCK BIKES ALLOWED. Pro riders from 250 & 450 Classes can not race in
the 85 Class.
Super Mini: Maximum engine displacement including overbores is 112cc two
strokes or 150cc four strokes. Wheel limits 19” front and 16” rear. Riders through
age 16 (non pro). Wheel base cannot exceed 56” from axle to axle. 65cc bike s
illegal.
250 A/B/C: Two stroke 125cc min - 250cc max, any 4 stroke 126-250cc, 250
stock 2 stroke; No age limit. 19” & 21” tires.
450 A/B/C: All 250cc class bikes, 4 stroke 250 – 450cc, 2 stroke 125cc, No age
limit. 19” & 21” tires.
Open School Boy: 250 Class bikes only. Open class. Ages 12-16 (non pro).
Super Minis not allowed.
Open Outlaw: 250cc bikes and up. Age 12 and above. Pro Riders only. A rider
may lose eligibility as an amateur in other circuits by entering this class. 100%
entry fee payback. No rider division.
Vet A/B: Age 30 and older, same bike specifications as Open Outlaw. Full entry
fee payback for A class only. Actual age on race day is the effective age.
Women’s Open: Women must be age 9 and older. Legal bikes for this class are
65cc Class bikes and larger. Women are eligible to race in all other C classes (ex.
Women Open can race 250C, etc.).
Open Amateur: 250 Class bikes and up. B/C riders only NO A RIDERS. No
max bore. 19” and 21” tire size. No age limit.
Effective Age - Age on January 1st of Current Race Season..
HPMA Yearly Membership Fee: Circle choice
Early Registration (Postmarked by April 1) ............ $35
Late Registration (Postmarked after April 1) .......... $55
Day Pass (Valid 1 day only, all classes)................................... $15
Amount Enclosed ______________________________
Send to HPMA Treasurer: Stacey Szymanski
PO Box 155 Glenrock, WY 82637
CLASS SELECTION: Select class, division, provide bike info.
Class
A B C
Bike Make and cc
Pee-Wee
50 Open
65
65 Open
85
250
450
VET
Women
Mini Non-Comp
School Boy 250
50 cc Expert
Super Mini
Open Outlaw
Open Amateur
A=Pro, B=Amateur, C=Beginner
RELEASE FORM:
As a rider in this motorcycle association, I hereby agree to
conform to and comply with all rules, regulations, and decisions
governing this association. It is understood and agreed that, I the
undersigned, am entering this association of my own free will and
that I am of legal age or have the consent of my parents or
guardian to participate in this association. I further agree to hold
blameless the officers & promoters of this association, the hosting
clubs, sponsors, property or tract owners and lessees for any
injury to myself or loss of property which may occur by reason
of my participation in this association and its activities.
I HAVE READ THE ABOVE RELEASE FORM & AGREE_________
(Initial Here)
Signature___________________________Date____________
If under 18 years of age, Parent or Guardian print & sign below:
Print Name_________________________________________
(Please print clearly)
Sign Name_________________________Date_____________
For Available Race No. Contact Bethany Ingle
Phone: 307-399-4719 e-mail: biff_ing@msn.com
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