We race in honor of our friend Mr. Will       

                             

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2010 Thunder Valley Driver Registration

 

Drivers Name___________________ Car#_____________        Division______________________________

Drivers Address______________________                     _______________________________________

_______________________________________

Drivers Phone #_______________________

Drivers E-Mail________________________

Drivers SS#___________________________

Drivers License #_____________________

Date of Birth_________________________

 Person Responsible for Car’s Earnings

Name_________________________________

Address_______________________________

_______________________________________

_______________________________________

Phone #_______________________________

SS#/ Fed ID#__________________________

 Sign________________________________Date_______________

By signing above I acknowledge that the above information is true and correct. I grant permission for my name and photo to be used by Thunder Valley. I have received and read a copy of Thunder Valley’s divisional and ground rules. I agree that I am mentally and physically able to compete at Thunder Valley.