PRESENTS
CRUZIER ENDURO MANIA
SEPT 28TH


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OFFICIAL ENTRY FORM (PLEASE PRINT)    ENTRY FEE $40 DRIVER & CAR
NAME_____________________________________________________________________AGE_______
SOCIAL SECURITY#______________CAR TYPE_______________________CAR #_________________
ADDRESS___________________________________CITY__________STATE________ZIP___________
I HAVE READ AND FULLY UNDERSTAND THE RULES OF THE ENDURO AND UNDERSTAND.
FAILURE TO OBEY OR COMPLY WITH THE RULES & REGULATIONS WILL MEAN MY
DISQUALIFICATION. I UNDERSTAND NO REFUNDS OF ANY KIND WILL BE MADE IN EVENT I AM DISQUALIFIED. SIGNATURE__________________________________________________________
MAKE CHECKS PAYABLE & MAIL TO:
BOETCHER MOTORSPORTS INC. 3510 LITTLE CREEK RD. FRANKFORT, OH 45628
NO CHECKS ACCEPTED AFTER SEPTEMBER 20TH