PORTAGE COUNTY RANDOLPH FAIR DEMOLITION DERBY MAIL-IN ENTRY

Send Form & Other Information To: P.O. Box 213 Randolph, OH 44265

Entry Fee $40 CASH -- AT TIME OF ENTRY!

PRIZE MONEY: $40 for the top three places in each full size heat. Features pay top four places: $1500 $750 $500 & $250. Compact cars no payout for each heat. Feature pays top three places: $500 $300 & $150. Entries must be mailed or delivered to the Fair Office with entry fee (money order if mailing) and a copy of your drivers license or photo ID. Deadline for mailing is Aug. 12th.

Pit Passes: Drivers pit passes is free with entry - all other pit passes are $10. Only persons 18 years and over are permitted in pit areas (restricted area). Pit passes only get persons into pit - not into the grandstand.

I, the undersigned, do hereby agree to enter this Demo-Derby at my own risk. In the event of injury, I shall not hold the promoter or Smash-It Demolition Derby's Inc. liable for injury to myself or my property. I have read the rules and accept the decision of the judges as final. I agree to have my car at the derby area and passed inspection by at least one hour prior to Showtime.

Falsifying any part of this entry form is grounds for rejection of entry and/or disqualification from the derby.

• Name
• Street Address
• City
• Zip Code
• Phone Number
• Birthdate
• Check Here If There Has Been a Change Of Address Yes
• Select which class you are entering. If you are entering both classes, you must fill out two entries. Large Car Compact Car
• Date
• Signature (sign here after you print)
• SS #

DO NOT WRITE BELOW

Name______________________________  Night_________________

Compact/Large Car__________  Age_________  Fee____________

© 2012 Portage County Randolph Fair

4215 Fairground Road

Randolph, Ohio 44265

330-325-7476

randfair@aol.com

Fair Meeting Dates