Power Wheel Demo Derby

At Sycamore Speedway

August 29, 2014

Rain Date scheduled for September 5, 2014

Drivers Name_________________________________________________

Drivers Hometown_____________________________________________

Drivers Age___________________________________________________

Description of Power Wheel_____________________________________

Color of Power Wheel__________________________________________

Number on Power Wheel_____________________(pick your favorite number)

Parents of the Driver___________________________________________

Drivers Hobbies_______________________________________________

Drivers T-shirt Size (please circle one)

2-4, 6-8, 10-12, 14-16, adult small, adult medium, adult large

The cost for the power wheel demo derby will be $25.00.

This will include:

1. Pit pass for the driver to be on the track during the derby only.

2. Pit pass for one parent/guardian to be track side during the derby only.

3. T-shirt for the driver.

4. Trophy for the driver.

Rules for the power wheel demolition derby.

1. Must bring your own power wheel to the track.

2. No car batteries can be used.

3. Must be wearing a helmet (bike or motorcycle), gloves, long sleeves, pants,

and close toed shoes (no sandals).

4. Must return this form to Sycamore Speedway by August 23, 2014 with

payment. Can turn form into either the pit shack or the main ticket

windows.

5. Must arrive at track between 6 and 6:30pm. Check in with Sam by the side

gate in the pits for registration and car drop off. Power wheels will be put in

grandstands for meet and greet.

I, _______________________, give my child,

_____________________, permission to run in the power wheel

demolition derby.