Print this page, fill it out, and mail to the address listed on the form below with your pre-registration payment ($25 to show, $75 for vendors)

PEBBLE PUSHERS

SCR8P FEST  11

By signing this form you release Pebble Pushers, Concord Motorsport Park, All of our Sponsors, Affiliates, and their workers from anything being stolen, vandalized, destroyed, and torn up. However if you are caught destroying or vandalizing anything at SCR8PFEST you will be prosecuted to the fullest.

Pre-Registration Due By   Sept. 12, 2008

Send to Pebble Pushers 6314 Chamar Cir. Kannapolis, NC 28081.

Make Check Payable to Pebble Pushers. Pre-Registration $ 25 / Vendors $ 75.

Name______________________________ Vehicle Make________________

Model______________________ Year__________ Club__________________

Address_______________________________ City______________________

State__________ Zip_____________ Phone #_________________________

 

Signature___________________________________ Date________________