Homestead Race Credential Form

In order to get your credentials' and parking pass created, the following information is required at least two weeks in advance. 

Please provide the following contact information:
 * Required Fields

Military Rate if applicable   (MA3, QM2, BM1,OSC,,,,)

                      Full Legal  Name  **

                              Date of Birth   **   (mm/dd/yyyy)

Drivers License #      *

                Dates you want to work, November   **  (15,16,17,18)

We meet at Publix (map is on the previous page) at 0700 to pick-up your credentials and head to the track.
As the days are long, this year we may ask if you would like to come in later on Friday and Sunday
so the early morning folks can quit earlier than usual, however we have to make sure we have enough
workers on any given day before we can make the offer.

    The concessionaire has us wearing their shirts, if you have one from last year, then please wear those. 
    Otherwise, let us know and we will have them when you show up to work.

        Do you need a Shirt (provided)   **    (Y/N)
        If  "Y" what size
*  (S/M/L/XL/2XL/...)

      Do you need a hat  (provided)    **    (Y/N)

                      Hotel rooms are for volunteers working more than one day.

         Do you need a Hotel Room   **    (Y/N)
        If  "Y" what nights
*  (15,16,17,18)

The information added below is optional, however it will provide the CPOA the ability to contact you if there is an issue.

                          Contact Phone  


(Comments: anything else, you would like to add.)

Validation Required
Type "RACE" in caps in the box to the right:                           *

Contact the Race Coordinator Chief Mike Short at:  His cell number is (954) 394-3573.


Miami Chief Petty Officers Association
All rights reserved.
Revised: 08/07/18

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