INTERNATIONAL DEMOLITION DERBY

 OFFICIAL COMBINE ENTRY BLANK

P.O. BOX 245, LAPORTE, IN. 46352

PHONE: 219-324-4813 OR 219-363-8896

INTERNATIONALDEMOLITIONDERBY.COM

(FILL IN AND MAIL PROMPTLY. PLEASE PRINT)

 

 

 

 

Show Date_______________________ Location__________________

 

Drivers Name_______________________________________________

 

Address ______________________________ City________________

 

 State _________ Zip ____________

 

Home Phone __________________ Cell Phone __________________

 

Make of Combine __________________________________________

 

Model ____________________ Trans __________________________

 

Sponsors  _________________________________________________

 

I HAVE READ THE RULES AND ACCEPT THE DECISION OF THE JUDGE AS FINAL AND ELECT TO USE THE GROUND OR TRACK IN ITS PRESENT CONDITION.

 

SIGNED ________________________________ DATE __________________

Only cash or money order payable to International Demolition Derby will be accepted. No Checks!