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HOLLYWOODMOTORSPORTS DRIVER ENTRY FORM Name________________________________ NICKNAME_______________ Address: _______________________________________Home Ph_________________ City ___________________ST __________Zip__________Cell Ph__________________ Class___________Car #___________ Car year/make/model ____________________________________________________
Sponsors ______________________________________________________________ Birthdate ____________________________ Email Address ________________________________________________ DRIVER AGREEMENT: My signature below confirms that I have read all rules and regulations & agree to abide by such. I understand that by participating in this event that I also agree to comply with the requirements set forth for this show. In addition, I agree to exercising good sportsmanship at all times during the event. I fully understand that if I am unable to participate for any reason that my entry fee is forfeited. I understand there are no refunds. I understand I am not able to sell or give away my entry, or otherwise make driver changes without first contacting this promoter. I understand if I am disqualified for any reason, I will not receive any refunds (including pit passes). This includes not passing inspections, if I am unwilling or unable to make the required changes .I understand that if I place and receive prize money that my social security number will be requested and I agree to provide given the circumstances. My signature below confirms that I understand and agree to these terms set forth. Drivers Signature_________________________________________________Date______ SEPT 5TH LABOR DAY 1PM START ROSHALT, OFFICIAL PORTAGE COUNTY FAIR CHECK YOUR CLASS YOU ARE ENTRYING ALL CLASSES ARE THE SAME AMOUNT $40 PRE ENTRY $60 THE DAY OF OPEN CLASS__________ COMPACTS________ MIDSIZE_______ MULTIPAL MINIES______ HOLLYWOOD MOTORSPORTS 2777 WESTMOOR RD OSHKOSH WI. 54904 CHARITY DERBY SET 17TH 12:30 START TEAM DERBY______________$300 OPEN CLASS CLEAN UP HEAT___________$50 MULTIPAL MINIS______________$50 MIDSIZE____________$50 TRUCKS________________$50 MAKE CHECKS OUT TO ELDORADO LIONS CLUB AND SEND TO CRASHING FOR A CAUSE W9261 COUNTY N ELDORADO WI. 54932**DO NOT MAKE MONEY ORDERS OUT TO JOE KOPF OR HOLLYWOOD. |