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Demolition Derby - Registration

Kanabec County Fair 2012

           Entry Form

Additional entry forms/rules can be printed at www.kanabecfair.org

make checks payable to the “Kanabec County Fair”

 

READ all  pages of The RULES  carefully. The rules will be strictly enforced!!!

 Pre registration: $35.00 Driver Only (July 19th or before)   Late entry:$45 Driver Only  (after July 19th)  

Extra Late inspection Fee (arriving after 6:45 pm) – additional $10               

Pit Passes $20.00 each

 

 Stock Trucks_____            Pro-Stock Cars _____       

 Mini Pick-Up Truck______       Semi-Stock Trucks  _____        Stock 80’s Cars _______

 

 Make______________________  Model__________________ Car No.______________

 

 Sponsor___________________________________________________________________

 

   I understand that the sponsors and administrators of the contest are not responsible for any accident, injury, damage or mechanical breakage should occur.  In consideration of you accepting this entry, I hereby for myself, my heirs, executors, and administrators, their agents, servants, and all other persons connected with these competitions of and from any loss, damage, or injury sustained by me or my equipment  during this competition.  Winners may be required to complete a W9 to collect prizes.

 

I am 16 years of age or older

 Name________________________________________Date of birth________

 

Address________________________________________________________

 

City__________________State_________Zip____________County_________

 

Phone Number____________________________

 

Signature of competitor____________________________________________________

if under 18 years of age, Parent or Guardian must sign the form and both signatures must be notarized

Signature of Parent or Guardian_____________________________________________

 

Subscribed and sworn to me before this_______day of ___________2012                                                       Notary public

 

 

Mail completed entry to:                                                                                

Rene Barn             308 union st           Grasston,  MN 55030

Any questions on the rules call Pete at 320-358-0865 or e-mail This e-mail address is being protected from spambots. You need JavaScript enabled to view it.