Print and Mail Registration Form

Woodbooger Demolition Derby
Lebanon County Fair
Mack Road
Lebanon, CT
August 8, 2008
7:30 PM

Name_________________________________________________
Address_______________________________________________
City____________________State__________ZIP_____________
Phone________________________________________________
E-mail Address__________________________________________
Number of cars entered:4cyl_____ 6cyl_____ 8 cyl _______
Car Number(s) ________________
Please mail your $75.00 entry fee, Money Order or Bank Check (No Personal Checks)
to:
Eileen Mann
283 Broadway
Taunton, MA 02780

If you have any questions please call Jim (508)577-6850
Jim or Eileen at (508)880-8941