TRIPLE POINTS RACE

TRIPLE STATE AND TRIPLE TRACK POINTS

Pre-Registration Form

Sunday July 16th, 2006

Practice starts at 11:00 am with a 1:30 pm scheduled gate drop

Riders Name _________________________________________

NBL # __________ Age ____ Class __________ Bike # _______

Date of Birth __________ State ____ License Exp Date ________

Class Only $15.00 __ [ Trophy __ or Trader __ ]

Family Discount $14.00 __ [ Trophy __ or Trader __ }

Points Only $10.00 __

Open Class (excluding 16 & over) $4.00 __

Payment must accompany this entry form. Please make checks payable to The Litchfield County BMX Group, Inc.

Send form and check to Kerry Palmer - 57 Meadowbrook Ln.-Torrington, CT. 06790

A sur-charge of $5.00 will be added to entry fees recieved on the day of the race. Please get these in early and save.