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PRE REGISTRATION FORM#______
Please note : PRE Registration ends August 12 h at 5pm
NAME: (print) ________________________ PHONE: ________________________ ADDRESS: ________________________ CITY/TOWN:_______________________ PROVINCE: ________________________ POSTAL CODE:_____________________ EMAIL ADDRESS:_____________________________________________________
***Only children under 12 years of age are free, over 12 must have a ticket***
Tuff Trucks, Top Trucks, Demolition Derby & Lawn Mowers ** Vehicles MUST be removed from the grounds disposal fee will apply if not gone within the week** VEHICLE INFORMATION VEHICLE NAME:_____________________ TYPE: ______________________ ENGINE MAKE: _____________________COLOR: ______________________ SPONSORS: __________________________________________________________________________ (If you would like to show case your vehicle in our program, please be sure to submit a picture with your form) RACERS CATEGORY TUFF TRUCK DEMOLITION LAWN MOWER RACING EXTREME TOPTUCK ALL RACERS MUST BE REGISTERED & CHECKED IN 2 HOURS PRIOR TO RACE AND MUST BE RACE
READY!!
PIT CREW INFORMATION: Pit crew passes are $65.00 per person, with a MAX of (2) two crew per driver. 1._________________________ $65.00 tax and service fee included 2._________________________ $65.00 tax and service fee included Additional pit passes are $95.00 per person, to a MAX of (3) guests per driver. 1._________________________ $95.00 tax and service fee included 2._________________________ $95.00 tax and service fee included 3._________________________ $95.00 tax and service fee included No alcohol in the pits until the last race of last event each day is completed! Driver Sign here: _______________________ DRIVER INFORMATION: Drivers are $200.00 per driver for the full weekend, with one spouse pass. Kids under 12 are free. This pass will also get you and your spouse into the concerts each night 1._________________________(Driver Name) 2._________________________ (Spouse Name) $200.00 tax and service fee included No alcohol in the pits until the last race of last event each day is completed! Driver Sign here: _______________________
IMPORTANT NOTES:
● All drivers, pit crew, family & friends, must show up with FULL identification to receive
their passes. ● Family & friends add ons will obtain their passes at will call. ● Drivers, spouses, and crew must enter through the racers gate will FULL identification
to sign their waivers and receive their credentials. SEND FORMS & CHEQUES TO: Email completed forms to: [email protected] OR Mail completed forms to: NAPA Bonnyville ATTN: Val Mattice 6201 50 Ave Bonnyville, AB T9N 2L9 PRE REG FORMS MUST BE RECEIVED NO LATER THAN AUG 12 TH . ANY FORMS AFTER THIS DATE WILL BE CONSIDERED A LATE REGISTRATION AND WILL BE CHARGED THE LATE REGISTRATION FEE. PAYMENT INFORMATION: ALL cheques can be made out to: Extreme Mudfest Bonnyville Inc. Please note that all preregistered drivers must be paid in full to race. Payment and registration form must be received no later than August 12th, 2016. Please note, all credit card payments will be charged a 3.5% credit card processing fee. Credit Card VISA MASTERCARD AMEX Card Number: ____________________________ Expiration Date: ____________________________ (MM/YY) CCV: ____________________________ (3 digit code on back of card) Card Holder Name: ____________________________ Signature: ____________________________
Cheque : Cheque enclosed Receipt: Please email my receipt No thank you PRE REG FORMS MUST BE RECEIVED NO LATER THAN AUG 12 TH . ANY FORMS AFTER THIS DATE WILL BE CONSIDERED A LATE REGISTRATION AND WILL BE CHARGED THE LATE REGISTRATION FEE.
