Paper Application: 2011
I have read and agree to the 2011 Trolley Derby Rules & Regulations
I am over the age of 18 and have the legal authority to enter all drivers listed below
I am aware that Trolley Racing might cause me injury and/or damage to my property
I wish to take part in the Trolley Derby despite these risks
| Signature: | ________________________ |
| Postal Address: | ________________________ |
| ________________________ | |
| ________________________ | |
| Email: | ________________________ |
| Phone (daytimes): | ________________________ |
| Phone (evenings): | ________________________ |
| Mobile: | ________________________ |
| Fax: | ________________________ |
| My/our Trolley is called: | ________________________ |
| I/we want to enter our trolley in the following grade(s): | |
| Nippers | ||
|---|---|---|
| Drivers Name: | ________________________________________________ | |
| born | 2004 to 2009 | |
| Entry Fee: | Free | |
| ONE of the following three grades: | ||
| Zoomers | ||
| Drivers Name: | ________________________________________________ | |
| born | 2000 to 2003 | |
| Entry Fee: | $10.00 | |
| Sprinters | ||
| Drivers Name: | ________________________________________________ | |
| born | 1996 to 1999 | |
| Entry Fee: | $10.00 | |
| Rockets | ||
| Drivers Name: | ________________________________________________ | |
| born | 1891 to 1995 | |
| Entry Fee: | $20.00 | |
| Monarchs | ||
| Drivers Name: | ________________________________________________ | |
| born | 1891 to 1995 | |
| Entry Fee: | Free | |