Sponsor: Cumberland Salvage INC. Sponsor: Lakeside Garage LAW ENFORCEMENT DEMOLITION DERBY Registration fee of $20.00 per car Registration fee does not include admission – Everyone Pays at the Gate Name:_____________________________________________________________ Age:_______ Address:___________________________________________________________ City, State, Zip:______________________________________________________ Email:__________________________________________ Phone:_______________________ Please register me for: Tuesday, September 29th, 2015 $___________________________ Car #___________________ $___________________________ Car #___________________ $___________________________ Car #___________________ All Entrants must return an Official Entry Blank, Registration Fee, and a signed Release Agreement to: Cumberland Farmer’s Club; Don Doyle, VP, Superintendent 72 Turkey Lane, Auburn ME 04210 (207)838-0108 OR: May be returned to the Main Office at the Cumberland Fair Grounds between 9a-3p September 22th - September 25th, 2015 Prizes for the Law Enforcement Derby are: Special Feature –1st Prize $700 plus Trophy; 2nd Prize $200 plus trophy I HAVE READ THE RULES AND ACCEPT THE DECISION OF THE JUDGES AS FINAL AND ELECT TO USE THE TRACK IN ITS PRESENT CONDITION: ___________________________________________________________ ________________________ Signature Date
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