2017 Race Entry Form

2017 ONE LUNGER 100 RACE ONLINE ENTRY FORM MUST BE 18 YEARS OLD TO RACE!! NO EXCEPTIONS. PRE REGISTRATION (any day before race.) DAY OF RACE $70.00 REGISTER BY 8:30 AM . ) MAIN EVENT $35.00- POWDER PUFF $25.00 – TWIN RACE $25.00 – MODIFIED CLASS $30.00 - NEW CLASS 85 AND OLDER $25.00 - KIDS RACE STOCK $15.00 - KIDS MODIFIED $25.00 PAYMENT OPTIONS PAYPAL.- IF NO PAY PAL YOU CAN ADD CREDIT OR DEBIT CARD INFO . CREDIT CARD OR DEBIT CARD LINK WILL BE LOCATED BELOW THE PAYPAL SIGN IN BOX
Name
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Date of Birth
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mm/dd/yyyy

Address
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City
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State
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Zip Code
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Telephone
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Email(*)
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Year Make and Model
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Race Number(*)
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Entry Fee(*)
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