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2007 Greene County Fair

Stanardsville, VA
Aug. 4th -- Saturday -- 7:00 P.M.; Gates Open 4:00 P.M.

AUTOMOBILE DEMOLITION DERBY
RAIN OR SHINE EVENT

TOTAL$1000.00 PURSE

     OFFICIAL ENTRY BLANK                       This is Your Car Number

(CLICK HERE FOR A PRINTABLE "WORD" VERSION)

(Please Print)

 

NAME ______________________________________ AGE__________  DATE OF BIRTH ________________
                                                                                                                                                                        Month/Day/Year

                                                                                                                                                                                       

DRIVER'S LICENSE NUMBER ______________________________ EXPIRATION DATE ___________

 

ADDRESS __________________________________________________________________________

 

CITY, STATE, and ZIP _________________________________________________________________

 

E-MAIL ADDRESS ____________________________________________________________________

 

I HAVE READ THE RULES AND WILL ACCEPT THE DECISION OF THE JUDGES AS FINAL AND ELECT TO USE THE GROUND OR TRACK IN ITS PRESENT CONDITION.

 

DATE ___________________ SIGNATURE _____________________________________________

 

PHONE NUMBER ______________________ CELL # ____________________________

 

Please indicate what type of Vehicle you will be entering (mark all that apply). Remember the entry fee is $25.00 per Vehicle entered.
Example Driver with 2 cars cost would be 2 x $25.00 = $50.00

SAT. AUG 4, 2007      4 Cyl _____________   V 6 _______________  V 8 _________________

TOTAL NUMBER OF CARS ENTERED

___________ x $25.00 = ____________

 

MAIL TO: STONEY ROBERTS PROMOTIONS, INC. C/O GREENE CO. FAIR
ATTN: Richard Durrer, P.O. BOX 153, STANARDSVILLE, VA 22973
Best Appearance Theme HARLEY DAVIDSON MOTORCYCLES

FOR INFORMATION CALL TOLL FREE 1-888-361-5767
or CONTACT DICKIE DURRER 1-434-985-7622

Fairgrounds located on Rt. 230 approx. 3-1/2 miles north of the intersection of Rt. 33