Establishing secure connection…Loading editor…Preparing document…

NHRA Pro Sportsman Competition License Application and Medical Certificate

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

NHRA Pro/Sportsman Competition License Application

THIS APPLICATION IS LIMITED TO APPLICANTS 18 YEARS AND OLDER

SECTION 1

Name: Date of Birth:

Address:

City: St: Zip:

Home Phone:

Cell Phone:

Email:

State Driver’s Lic #: Exp:

Corrective Lens Required While Driving?

NHRA Membership Acct #:

Competition License Number(s):

Last date of competition at NHRA Member Track:

SECTION 2

Circle the highest qualified license types & levels:

Pro/Sportsman Type A over 125” wheelbase Type B up to 125” wheelbase Type C Type D

Level 2: TAD, NTF, SPF TAFC, NFC, SPF PM, MMPS TFH, TFM, PFH

Level 3: COMP, TD, AdvET COMP, FX, TD, TS HU AdvETM

Level 4: SC, ET* SC, SG, SST, SS, STK, FSS, ET* ETM*, SM*, ATV*

Level 5: SST, SS, STK JrM ETM, SM, ATV

Select the requested categories:

SECTION 3

APPLICANT’S AFFIRMATION & AGREEMENT: I affirm that I have read and understand and agree to the NHRA rules and regulations...

APPLICANT’S MEDICAL ACKNOWLEDGMENT: I state and affirm that I am in good health and physically and mentally able to participate...

Applicant Signature: Date:

SECTION 4

Type Of Vehicle Used For The Runs (make, model, & wheelbase):

Cockpit Orientation Test

1. HALF PASS

ET: MPH:

Date: Location:

Licensed Driver 1:

Category / License Number:

Licensed Driver 2:

Category / License Number:

Track Official:

2. MODERATE PASS

ET: MPH:

Date: Location:

Licensed Driver 1:

Category / License Number:

Licensed Driver 2:

Category / License Number:

Track Official:

3. MODERATE PASS

ET: MPH:

Date: Location:

Licensed Driver 1:

Category / License Number:

Licensed Driver 2:

Category / License Number:

Track Official:

4. MODERATE PASS

ET: MPH:

Date: Location:

Licensed Driver 1:

Category / License Number:

Licensed Driver 2:

Category / License Number:

Track Official:

5. FULL PASS

ET: MPH:

Date: Location:

Licensed Driver 1:

Category / License Number:

Licensed Driver 2:

Category / License Number:

Track Official:

6. FULL PASS

ET: MPH:

Date: Location:

Licensed Driver 1:

Category / License Number:

Licensed Driver 2:

Category / License Number:

Track Official:

SECTION 5 – ALL PAYMENTS MUST BE IN U.S. FUNDS

Method of Payment:

Enclosed is a or in the full amount

Charge my:

Amount to Charge on Credit Card: $ Card #: EXP: CCV Code:

Print Name as it appears on the card: Signature: Billing Zip Code:

NHRA COMPETITION LICENSE & MEMBERSHIP FEES

NHRA License & Number; First Category (Level 2, 3, 4)

NHRA License & Number; First Category (Level 5 only)

Each Additional Category QTY x $20.00 / x $10.00

SELECT A NHRA NATIONAL DRAGSTER PUBLICATION TYPE

Print & Digital Membership (US)

Additional Postage (Can/Mex)

Additional Postage (Foreign)

DIGITAL ONLY Membership (US, Can/Mex, or Foreign)

OTHER NHRA COMPETITION LICENSE FEES

Replacement/lost or stolen license

TOTAL DUE $

FOR OFFICIAL NHRA USE ONLY

RCV’D: AUTH. BY:

ACCT. #: MED DATE: CLR: Y N

LIC. CODE: DATE ISSUED: EXP DATE:

TOTAL AMT. ENCLOSED: $ NFO $ ND $

CHECK #: VS / MC / AX / DR:

COMP #’S:

NOTES:

APPLICATION FOR DRIVER'S MEDICAL CERTIFICATE

Applicant’s Full Name & Address

Name:

Address:

MEDICAL HISTORY

Remarks:

Medical treatment including surgical procedures within the last 5 years:

Applicant's Signature (in ink): Date:

REPORT OF MEDICAL EXAMINATION

Applicant’s Name: Age: Date of Birth:

Height: Weight: Hair: Eyes: Sex:

Blood Pressure: Systolic Diastolic Heart Rate:

Field of Vision:

Corrective Lens Required While Driving:

Right Eye: Left Eye: Both Eyes:

Urinalysis:

Blood Sugar Test: Fasting 2-Hour P.P. HgA1C

Other Tests:

Disqualifying Defects/Limitations:

Comments on History and Findings, Recommendations:

EKG Date:

Please check one:

Date of Examination: Medical Physician Signature & State License Number:

Medical Physician Name, Title, Address & Phone:

NHRA COMPETITION LICENSE DIRECTIONS

Complete Sections 1-3. Before Section 4, arrange licensed drivers and track official to observe test runs. Section 4 includes required pass sequences for new driver, renewal, level/type change, and transfer applications. Full runs must match category standards.

NHRA COMPETITION LICENSE REGULATIONS

General regulations include age minimums, physical requirements, license validity periods, run standards, and category/class abbreviations. Applicants should review the rules applicable to their license level and category.

Enter text✕
Prepare your document for signing right on this page
  • 01 Edit the text and complete the fields
  • 02 Click Sign Now and on the next screen add recipients and signature fields in SignNow
  • 03 Start your free trial to sign and send your doc
Sign Now

What the NHRA Pro Sportsman Competition License Application and Medical Certificate Is

The NHRA Pro Sportsman Competition License Application and Medical Certificate is a combined form used to request a Pro Sportsman competition license and to document medical clearance from a licensed healthcare provider. It captures applicant identification, racing history, emergency contacts, and a clinician's physical exam findings and attestation. Organizers use the completed document to verify eligibility and to confirm that the driver meets minimum health and safety standards before being permitted to compete in NHRA-sanctioned Pro Sportsman events.

Why this combined application and medical certificate matters

This form streamlines licensing and medical clearance into a single record that event officials, medical staff, and insurers can review to confirm fitness to race and to reduce administrative delays at event check-in.

Why this combined application and medical certificate matters

Primary users and stakeholders

The form is completed by applicants and their medical providers and reviewed by NHRA licensing staff and event officials.

  • Race applicants and drivers responsible for providing accurate personal, license, and medical details before competing.
  • Licensed physicians or advanced practitioners who perform the exam and certify medical fitness for competition.
  • NHRA licensing officials and event medical staff who accept, review, and retain the form for eligibility and safety oversight.

Teams, medical personnel, and insurers also rely on the document for safety decisions and claims validation.

Core components to include in a professional submission

A complete form balances administrative data and a clear medical attestation so officials can quickly assess eligibility without follow-up.

Applicant Details

Full legal name, date of birth, NHRA membership number, contact information, and current residential address for identification and verification purposes.

Racing History

Prior license classes, recent competition history, and any suspensions or medical restrictions that could affect eligibility or required oversight at events.

Medical Exam

Physician findings including vital signs, relevant diagnoses, medications, and functional assessment focused on cardiovascular, neurological, and musculoskeletal fitness to compete.

Physician Attestation

Signed statement from a licensed clinician confirming the applicant meets medical standards for Pro Sportsman competition and noting any limitations or required follow-up.

Emergency Contacts

Designated emergency contact name, relationship, and phone numbers for use by event medical personnel and officials in case of incident.

Release and Insurance

Acknowledgement of event rules, release language, and insurance information to clarify liability boundaries and coverage when competing.

Required information fields at a glance

Full Name: Enter legal name used for NHRA records.
Date of Birth: Use MM/DD/YYYY format.
Address: Include street, city, state, ZIP.
NHRA Number: Provide current membership or license number.
Medical Summary: Concise summary of relevant conditions.
Clinician Attestation: Physician name, license, and signature.

Step-by-step completion checklist

Follow these steps in order to reduce processing delays and ensure the form is accepted by NHRA licensing staff.

  • 01
    Gather IDs: Collect government ID and NHRA membership details.
  • 02
    Complete applicant fields: Fill personal and racing history accurately.
  • 03
    See a clinician: Obtain a physical exam focused on racing fitness.
  • 04
    Submit and retain: Send completed form to NHRA and keep a copy.

How to configure an online submission workflow

Set up a digital workflow that captures applicant entries, routes to clinicians, and archives a signed certificate with an audit trail.

Field | Configuration Input | Validation
Applicant Email Required | Email format check
Physician Upload Required | PDF or image allowed
Signature Field Required | Date-stamped audit trail
Storage Encrypted | Read-only archive

Typical routing from applicant to final acceptance

A clear routing model helps prevent lost records and ensures the clinician's attestation reaches licensing staff promptly.

  • Applicant submits: Uploads form and ID documents.
  • Clinician completes: Performs exam and signs certificate.
  • NHRA reviews: Staff verifies completeness and eligibility.
  • Record retained: Final document archived securely.

Digital signing and integration considerations

Choose a platform that supports secure e-signatures, audit trails, and integration with storage systems used by licensing staff.

  • File formats: PDF and DOCX accepted.
  • Integrations: Salesforce, Google Workspace, NetSuite supported.
  • Authentication: Email or multi-factor signer verification.

Ensure the chosen workflow preserves the audit trail, offers encryption in transit and at rest, and supports HIPAA handling when medical data is present to meet organizational and legal requirements.

Timing considerations and when to submit

Plan submissions to accommodate clinician availability and NHRA processing times before the first scheduled competition date.

Pre-event submission window:

Submit in advance per event guidelines to avoid day-of disqualification.

Renewals:

Complete renewals before current license expiration.

Post-incident re-evaluation:

Provide updated medical certificate after relevant injuries.

International transfers:

Allow additional time for credential verification.

Late documentation:

May delay or prevent event participation.

Common preparation mistakes to avoid

  • Incomplete clinician sections that omit license numbers or signatures create processing delays and often require resubmission.
  • Name mismatches between ID, NHRA record, and the application can lead to identity verification failures and event access issues.
  • Using informal abbreviations for medical conditions or medications can obscure assessment and prompt follow-up questions from medical staff.
  • Failing to retain a copy of the signed certificate makes it difficult to respond to insurance or eligibility disputes after an incident.

Possible consequences of incorrect or missing information

License Denial: Application may be refused.
Event Disqualification: Participant could be barred from competition.
Insurance Issues: Claims may be denied or limited.
Medical Liability: Provider documentation gaps increase risk.
Administrative Delays: Processing time increases.
Record Inaccuracy: Leads to future eligibility disputes.

Comparison: eSignature vendors for submitting and storing forms

Select a vendor based on required features such as HIPAA support, bulk send, audit trails, and pricing model; signNow is listed first for comparison.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day trial Varies by plan Varies by plan Varies by plan Varies by plan
Bulk Send Yes (premium) Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year Varies by plan Varies by plan Varies by plan

Practical examples of completing and using the form

Two concise scenarios illustrate how a driver and a team handle application and medical certification in routine and expedited situations.

Regional Racer Applicant

A competitor prepared documents two weeks before an event, secured an exam from a local clinic

  • clinician confirmed fitness with clear vitals and no restrictions
  • NHRA accepted the complete submission without follow-up, allowing on-time participation and a retained digital copy for team records.

Team Medical Clearance

A sponsored team centralized submissions to reduce errors by standardizing the form

  • they required clinicians to include license numbers and contact details
  • the consistent data reduced verification calls and improved administrative throughput at multiple events.

Practical tips for accurate and efficient completion

Adopt consistent practices that reduce rework, protect privacy, and preserve evidentiary value of the signed medical attestation.

Use a verified ID
Match the name on the application to government photo ID and NHRA records to avoid identity verification failures during check-in.
Choose secure eSign
When sending PHI, use a vendor that offers a BAA, encryption, and an immutable audit trail to meet HIPAA expectations.
Preserve the audit trail
Keep signed copies with timestamps, IP addresses, and signer attribution to support admissibility and incident reviews.
Document changes promptly
If medical status changes, obtain an updated clinician attestation and submit it before returning to competition to limit liability and insurance gaps.

Frequently asked questions and clarifications

Answers to common questions about e-signing, notarization, retention, and medical attestation help reduce uncertainty for applicants and clinicians.


Need help? Contact support

Explore Templates

Florida Tenant Complaint Florida Motion to Reopen Case Florida Statement of Claim Form Florida Summary Judgment Motion for Summary Judgment Writ of Certiorari
be ready to get more
Join over 28 million airSlate SignNow users
Sign Now
Company
Forms
Pricing
Resources
Knowledge base
Other Products
© 2026 airSlate Inc. All rights reserved.