Registration Form

 







2019 Fall Bent Promotions Pre-Registration




Participant Printed Name.....................................



Drivers #......

ADDRESS.........................................

CITY.................................. STATE....... ZIP........

PHONE WITH AREA CODE.............................


Please mark the box below for the class you are participating in.


Make all payments to Bent Promotions LLC


o         RWD Street Stock $150


o         FWD Street Stock $125


o                  Mini Trucks $125







SIGNATURE................................................ Date………..


 





 

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