Cost is $35.00 each
Entitles a $5.00 discount of pit pass at any
UMA track, Dells Raceway, Marshfield, State Park, Golden Sands.
Valid for card holder only.
PERSONAL INFORMATION
First Name: 
Last Name: 
Address: 
City: 
State: 
Zip: 
Phone: 
Email: 
Name on UMA Card: 
BILLING INFORMATION
Credit Card #: 
Exp Date (ex.02/17):   / 
CVV2 (Code on back) #: 
Price:  $35



N1070 Smith Rd.   Wisconsin Dells, WI 53965    Phone: 608-253-7223