utahSBA | Membership Form

The form below is to allow you to sign up for membership using our shopping cart system, which is processed by paypal. You do not need a paypal account to purchase a membership, but if you do not have paypal you will have to have a credit card (or a debit card with a visa/mastercard logo). If you do not have a paypal account or credit card, or simply prefer not to give that information out over the web, we have a Mail Order Form you can use. You can also sign up at any of our track events or USBA meetings.

Required fields noted with *

Personal Information

First Name*
Last Name*
Address*
City*
State*
Zip*
Home Phone*
Work Phone
Cell Phone
Email*

This address must be valid, as we will be sending you your membership information to this address.

Date of Birth*
MonthDayYear
Do you have a motorcycle endorsement on your license?*
What do you ride?

Emergency Contact Information

Name*
Phone Number*

Human Verification

How many wheels does a motorcycle have?*

Race License Information

AMA Number*
AMA Expiration *
Month Year
All new race license requests are set to Provisional Novice until proof of previous race experience has been provided to membership@utahsba.com
Choose 3 possible race numbers in order of preference
Experts = 2 digits / Novice = 3 digits
Race License Comments
(if applying for expert class, explain previous race experience that warrants expert status)

Note: the license you purchase online is dependant on proof of current AMA Membership and required previous experience if applying for Expert status. Failure to provide proof at race registration will nullify your race license.