Print & Mail Registration Form

Woodbooger Demolition Derby
3 County Fair Grounds
41 Fair St.
Northampton, MA
October 3, 2009

Name____________________________________________

Address__________________________________________

City_______________________State__________ZIP_____

Phone___________________________________________

E-mail Address___________________________________

4 cyl ________________________ $75.00 Entry Fee

6 or 8 cyl_____________________$150.00 Entry Fee

Number of Your Car ________________

Please mail your entry fee payable by 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