Bret Chevrolet “100” Stock Car Challenge

NW Legends Support Race

August 19& 20,2006

Practice Day (Aug.18 Fri.) &150.00

TWO DAY ONLY RACE ENTRY FEE (Sat. & Sun.) $185.00

Postmarked by August 10,2006 After August 10 add $25 late fee.

As an ENTRANT and /or Driver. I make this request for entry into this event with full knowledge that motor racing is dangerous, and that I will be required to sign a “release form”. Driver/Entrant

further acknowledges, that Legends racing may involve danger not present in contemporary racing including, but not limited to, lack of contemporary safety equipment in his own or in competitors cars such as roll cages, fuel cells, fire systems, etc., and race grouping which may include different types of Legends in the same group creating potential problems of visibility and disparate speed potentials. This section must be signed for entry to be accepted.

Entrant/Driver Signature Date

LEGENDS ROAD RACE INFORMATION

Make ______________ Model_______________Year_______Color_______________

Car # ____Need to rent AMB Transponder ______ If no, AMB Transponder# _________

DRIVER INFORMATION

Name___________________________ Street Address ___________________________

City, State, and Zip ________________________________Phone__________________

Email_________________________ Inex Lic # ________________________

Is this your 1^st race @ Pacific Raceways _________

Crew #1________________________ Crew #2 ______________________

Crew #3 ________________________Crew #4 ______________________

Practice Day Fee @ $150.00 ________*

Two Day Entry Fee @$185.00 ________ * MAIL THIS FORM AND CHECK

Crew Pit Pass Fee @ $35.00 _________ PAYABLE TO:

Late Fee @ $25.00 ________

Transponder Fee @ $50.00 _________

Total _________ Pacific Raceways

31001 144^th Ave SE

(Credit Card Payment (Visa/Master Card Only) Kent, WA 98042

Must be called in to 253-639-5927 ext 103)

*$25.00 of entry fee is non-refundable if entry is cancelled after August 10^th. Call Steve at 253-639-5927 Ext 103 to cancel