REGISTRATION FORM
GREEN GRAND PRIX 2012
2012 Doris Bovee Memorial Road Rally Events Friday Road Rally on WGI short course 135 miles Saturday Road Rally on public roads 140 miles Both Friday and Saturday Road Rallies No extra charge
CONTACT INFORMATION
Contact Name
Company Name (if applicable)
Address
City State Zip
Day Phone Eve Phone
Cell Phone Email
Vehicle Make Model Year
Vehicle fuel
Private entry (covers driver and navigator) $75 Business/Organization entry covers driver and navigator $150 School/Educational
Additional passengers excluding driver and navigator (please add $15 insurance per person). This is also true for additional passengers in school entries. All minors under 18 must be accompanied by parent or legal guardian. If unaccompanied, they must have a presigned and notarized waiver.
Each entry will receive 2 Green Grand Prix T-shirts.
Please complete, print out, and mail to :
Green Grand Prix Corporation2888 Sherman Hollow Road Penn Yan, NY 14527
with check made payable to Green Grand Prix Corporation Questions? Please call Robert Gillespie (315) 694-2812