Truck Derby
Saturday, June 25, 2011
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Truck Derby Entry Form
Entrant's Name: ________________________________________________________________________
Age: ____________
Address: ______________________________________________________________________________________________
______________________________________________________________________________________________
Phone #: _________________________________________
$30.00 Entry Fee
Driver and Crew Chief will receive free pit passes at check-in on the day of the event. Additional crew members/spectators may purchase pit passes for $10 each. In order to obtain pit passes all individuals must sign a waiver.--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Mail entry:
Putnam Co. Ag. Society, P.O. Box 47, Ottawa, OH 45875Please make entry fee checks payable to: Putnam Co. Ag. Society