The "HALLOWEEN SCREAMER" Championship Enduro

Saturday, October 29, 2011 (1:00 PM Start)

4 Cylinders - 150 Laps    6/8 Cylinders - 150 Laps

$500 to win!!! (Guaranteed for 25 Cars)

Driver's Name: _________________________________________________________________________________

Address: _____________________________________________________________________________________

City: __________________________________ State: ____________________ Zip Code: _______________

Phone # (______)______________________   Email: ___________________________________________

Driver's Social Security # (all checks will be made payable to Driver): ________________________________

VEHICLE INFORMATION:

Year: __________________ Make: _______________________________  Model: __________________________

Car # Requested: __________________________________

Sponsors: _____________________________________________________________________________

                ______________________________________________________________________________   

DIVISION: (circle one):                     4 Cylinder                  6/8 Cylinder

**NOTE** Starting positions will be determined by the order that the entries are received

ENTRY FEE:     $75 (Reduced fee for 2010)

Make check or money order payable to: Mountain Speedway