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                                                     TEXAS THUNDER SPEEDWAY

                                               DEMO DERBY REGISTRATION FORM

                                    

 

DEMO DERBY DATE  (circle one):          MAY 4               JULY 27               AUG 31

 

DATE:__________________     CAR #_________________     CLASS:       DEMO DERBY

DRIVER'S NAME: ______________________________________  SSN: ______________________

ADDRESS:_____________________________________________  PHONE #:__________________

CITY:__________________________________   STATE:___________    ZIP:__________________

EMAIL ADDRESS: _____________________________________

CAR OWNER'S NAME (if different from driver):____________________________________________

CAR OWNER'S ADDRESS: __________________________________________________________

                                                                             SPONSOR'S

PRIMARY SPONSOR: _________________________________  CITY:_______________________

SPONSOR: ___________________________________________  CITY:_______________________

SPONSOR: ___________________________________________  CITY:_______________________

SPONSOR: ___________________________________________  CITY:_______________________

SPONSOR: ___________________________________________  CITY:_______________________

SPONSOR: ___________________________________________  CITY:_______________________

I agree to abide by all Texas Thunder Speedway Rules and Regulations.   I hereby give Texas Thunder Speedway the right to use pictures of my car or myself for promotional purposes.

              

                                                                                                               Driver's Signature:

                THE FOLLOWING INFORMATION IS NEEDED FOR IRS REPORTING

NAME: __________________________________________    SSN: ___________________________

ADDRESS:_________________________________________________________________________

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CAR #____________________       SPONSOR CARD -  Y   or   N

REGISTRATION FEE:     $40    

REGISTRATION PAID:__________       DATE PD: ____________       INITIALS:____________