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Wilkin County Fair
Breckenridge, Minnesota


DEMOLITION DERBY REGISTRATION FORM

(Please type or print. This form must be printed out and mailed to the address listed below along with your entry fee.)

Driver's Name: ___________________________________________________

Address: ________________________________________________________

City, State, Zip ___________________________________________________

County _________________________________________________________

Phone: _________________________________________________________

Driver's License No: _______________________________ State: __________

(Please check)
Thursday: Compact Car (  )        Sunday: Full Size Car (  )       Truck Derby (  )
Video (  )

  Pit Crew:  
  #1 ___________________________  
  #2 ___________________________  

The Driver and TWO Pit Crew Members will be allowed in with the registration fee.
 

All other pit crew members pay spectator fee and must have wrist bands provided by the fair board to enter.

The registration fee must be sent along with registration form to:
Max Roberts - 217 South 4th St.- Breckenridge, MN 56520
1-701-403-4626
Please make check payable to "Wilkin County Fair Demolition Derby".
(No Cash.  Do Not Post Date Check)

No refunds are available for any reason. There will be a $25 charge on all checks that don't clear the bank and the check will be turned over to law enforcement.

I have read the rules and accept the decision of the judges as final. I agree to use the track in the present condition. I understand that the sponsors and administrators of the contest are not responsible for liability in any accident, injury, damage or mechanical breakage, should any occur. In consideration of the acceptance of this entry, I hereby for myself, my heirs, executor and administrators, release and forever discharge the sponsors, administrators, their agents, servants and all other persons connected with these competitions of and from any and all rights, claims, demands and actions whatsoever that I  may have for any and all loss, damage or injury sustained by me or my equipment during said competitions. Note: There will be no refunds for late scratches.

NOTE: All Protest are between only the driver and firemen....
.no spectators, pit crew.... otherwise you may be disqualified!!

ONLY ENTRIES UNDER 18 MUST HAVE PARENT AND NOTARY SIGNATURE!

 

Subscribed and sworn to before me this ____________________, 2011.
Notary Public _____________________________________________
My Commission Expires _____________________________________


 

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