Event Entry

To Enter fill in the information below and click the Enter Event button.
* - denotes required fields

Race registration fees are $150.00 for the first event entry and $50.00 for additional events. Junior registration fee is $50.00 and the junior age group is 8 - 13 years of age. Online registration closes Thursday July 17,2008 11:59pm all entries after this date must bring all necessary printed forms to the event and will be charged a late fee of $25. (Check boxes for classes and events you wish to enter.) All payments are to be made in US Dollars.

Pro Streetluge

Am Streetluge

Pro Speedboard

Am Speedboard

Buttboard

Gravity Bike

Inline Board
(Dirt Surfer�)

Junior

Streetluge or
Buttboard

Special Events for this race include Practice and Bucket Brigade.
�	Practice will be available through out the day for racers entering enter one or more events at no additional cost. Those wishing only to practice will be allowed to do so for a fee of $50.00 for both days.
�	Bucket Brigade will consist of a three leg interdisciplinary event that is free to racers entering two or more classes. Those wishing to enter the Bucket Brigade that are not entering at least two classes will be allowed to do so for a fee of $25.00.

Practice
Both Days

Bucket Brigade

This is a Late Entry and the $25.00 late fee applies
Entries $ US Total

First Name:*

Last Name:*

Address 1:

Address 2:

City:

State/Providance:*

Other:
To enter a state other than US select Other from the State/Providance list and fill in the Other field

Zip/Postal Code:

Country:*

Home Phone:

You must enter at least one phone number

Cell Phone:

Work Phone:

Email Address:*

Nick Name:

Birth Date:*

You must select Birthdate. Click on the calendar button to select a Birthdate

Sex:*

Height

Weight

Leather and Helmet
Design / Color

250 Charters Max / Charters Left

Racing Number

Parent or Guardian Name

(If rider is under the age of 18 a parent or guardian MUST be present at event)

Racing Experience

250 Charters Max / Charters Left