Roadeo Registration

System Information

Please note: The first three contestants listed in the same vehicle category will automatically be entered in the team competition.

Number Contestants

Price Per Contestant

Price: $150.00

Contact Name*

First Last

Contact Email*

Enter Email Confirm Email

Contact Phone*

System Name*

System Address*

Street Address Address Line 2 City State ZIP Code

Weekend Contact Name*

First Last

Weekend Contact Phone*

Contestant information

Please note: The first three contestants listed in the same vehicle category will automatically be entered in the team competition.

First Contestant Name*

First Last

First Contestant Shirt Size*

First Contestant Category*

Second Contestant Name*

First Last

Second Contestant Shirt Size*

Second Contestant Category*

Third Contestant Name*

First Last

Third Contestant Shirt Size*

Third Contestant Category*

Fourth Contestant Name*

First Last

Fourth Contestant Shirt Size*

Fourth Contestant Category*

Fifth Contestant Name*

First Last

Fifth Contestant Shirt Size*

Fifth Contestant Category*

Sixth Contestant Name*

First Last

Sixth Contestant Shirt Size*

Sixth Contestant Category*

Seventh Contestant Name*

First Last

Seventh Contestant Shirt Size*

Seventh Contestant Category*

Eighth Contestant Name*

First Last

Eighth Contestant Shirt Size*

Eighth Contestant Category*

Ninth Contestant Name*

First Last

Ninth Contestant Shirt Size*

Ninth Contestant Category*

Number of Volunteers

First Volunteer Name*

First Last

First Volunteer Shirt Size*

Second Volunteer Name*

First Last

Second Volunteer Shirt Size*

Third Volunteer Name*

First Last

Third Volunteer Shirt Size*

Fourth Volunteer Name*

First Last

Fourth Volunteer Shirt Size*

Fifth Volunteer Name*

First Last

Fifth Volunteer Shirt Size*

Sixth Volunteer Name*

First Last

Sixth Volunteer Shirt Size*

Seventh Volunteer Name*

First Last

Seventh Volunteer Shirt Size*

Eighth Volunteer Name*

First Last

Eighth Volunteer Shirt Size*

Ninth Volunteer Name*

First Last

Ninth Volunteer Shirt Size*

Tenth Volunteer Name*

First Last

Tenth Volunteer Shirt Size*

Total

$0.00

Payment Option*

Pay by Credit Card
Pay by Check

Please make the check payable to: NCPTA

Upon submission, you will receive a registration confirmation email. Please print a copy of your registration confirmation and include it with your payment, which can be sent to the address below. Please remember that payment must be received prior to the start of the conference. No checks will be accepted on site.

NCPTA
P.O. Box 30160
Greenville, NC 27833

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name