Missouri Mini Truck & Mini Rod Pullers Association

Membership/Participation Registration Form


This will register an individual or family of pullers for one year of membership and participation at all MMTMRPA meetings and pulling events. MMTMRPA yearly membership dues is $100.00 per individual, or $75.00 per family. And being the MMTMRPA is not-for-profit organization, monetary contributions and donations would be appreciated to help cover insurance costs and various other operating expenses of the club. Please read, print out and fill out this form. Please make checks payable to MMTMRPA. Return to MMTMRPA Home Page


Name (Owner of Compact Truck or Mini Rod):__________________________________________________________________________

Address:____________________________________________City:_______________________________State_________ Zip:____________

Home Phone:_____________________________________________Cell Phone:_______________________________________________

Emergency Contact:________________________________________________________________________________________________

Email Address(es):_________________________________________________________________________________________________
Please check one: Compact Truck [_] Mini Rod [_]

Driver/Puller Name:____________________________________________

Name of Pulling Vehicle:________________________________________

Year, Make, Model & Engine Size:________________________________

Class:_______________________________________________________

Please check one: Compact Truck [_] Mini Rod [_]

Driver/Puller Name:____________________________________________

Name of Pulling Vehicle:________________________________________

Year, Make, Model & Engine Size:________________________________

Class:_______________________________________________________

Please check one: Compact Truck [_] Mini Rod [_]

Driver/Puller Name:____________________________________________

Name of Pulling Vehicle:________________________________________

Year, Make, Model & Engine Size:________________________________

Class:_______________________________________________________

Please check one: Compact Truck [_] Mini Rod [_]

Driver/Puller Name:____________________________________________

Name of Pulling Vehicle:________________________________________

Year, Make, Model & Engine Size:________________________________

Class:_______________________________________________________

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