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Official Entry Blank
Entry Fee is $ 100.00. This
blank may be brought filled out to the race track.
There is no pre-entry any
longer. Competitors are encouraged to call Phil Perry at (916)
408-4718 to state intention to compete for media purposes.
Driver Name: ______________________________
Date of Birth_________
Drivers Address: _______________________________________________
Car Owners Address: _____________________________________________
Street Address Apt. #
_____________________________________________________
City
State
Zip Code
Drivers Phone # (______)_________________
Westcar License # 07-_______( enter 3 digit number)
Drivers Signature_________________________________
Drivers Social Security # ________________________________
Primary Sponsor ______________________________________ Car
Make __________
*
If purse check is to be paid to someone other than
driver fill out the section below.
Car Owners Name:_____________________________________________
Car Owners Address:____________________________________________
Street Address Apt. #
_____________________________________________________________
City
State
Zip Code
Car Owners Phone # (______)____________________
WESTCAR License # 06-_______( enter 3 digit number)
Car Owners Signature__________________________________
Car Owners Social Security #__________________________________
Entry is $ 100.00
Agreement to abide by rules.
By signing the above entry blank you agree to
abide by all rules & terms of Westcar.
Westcar reserves the right to remove any person
from competition at anytime it is deemed necessary. |
