GENESEE COUNTY FAIR

2013 DEMOLITION DERBY

FRIDAY JULY 19TH 2013

$1000.00 TO WIN

 

EACH HEAT WILL PAY $100.OO FOR 1st

     $50.00 FOR 2nd

 

IF YOU ARE ENTERED BY JULY 10th 2013 ENTRY FEE $30.00

IF ENTERED AFTER JULY 10TH 2013 FEE $35.00

 

NAME:________________________________________________

 

ADDRESS:__________________________________________________________________

 

______________________________________________________________________________

 

PHONE:___________________

 

Number of years Driving Demos_______________

Demo Accomplishments:____________________________________________

______________________________________________________

 

I CERTIFY THAT I HAVE FULLY READ ALL OF THE RULES AND REGULATIONS PERTAINING TO THIS DEMOLITION DERBY

 

________________________                         _______________

  SIGNATURE                                                         DATE

ENTRYS CAN BE MMLED TO:

MAZURS AUTO

643 E MAIN ST

BATAVIAN.Y. 14020

585-344-2142

ANYONE UNDER 21 YEARS OF AGE MUST HAVE A MINOR RELEASE WAIVER SIGNED BY PARENT OR GUARDIAN THE DAY OF THE DEMO