SAGINAW  NDR SUPER NOVA II REGIONAL QUALIFIER

JULY 5 & 6, 2008

 

 

Racer's Name ___________________________________________________________

Address ________________________________________________________________

City ___________________ State ______ Zip Code ______________  Age _______

Daytime Phone # ________________ Night Time Phone # ______________________

Car Number ____________________  Cell Phone # ________________________

Division (Please Circle):        Stock        Super Stock        Masters

   Addition Racer(s)

   Name _________________________________ Age ________ Car # __________  Division __________

   Name _________________________________ Age ________ Car # __________ 

Entry Fee:  $35.00 for each racer per race and $30.00 each for additional family members.

Send Fees and Registration Form to:        S.S.B.D., % Cheryl Dietzel, P.O. Box 220, Freeland, MI 48623

For more information:  Contact Vaughn Dietzel (989) 790-7613 - home or (989) 239-1638 – cell or Call (989) 75-DERBY

Remember your State Flag and come have some great fun!!

 

(Flags will be returned to Owners.)

 

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