Sponsor: Cumberland Salvage Inc. Sponsor: Lakeside Garage 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: Sunday, September 27th, 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 21st - September 25th, 2015 Prizes for the Feature of each Heat of the Derby are as follows 4 Cylinder Heat: 1st Prize $300 plus trophy; 2nd Prize $150 plus trophy Full Size Heat: 1st Prize $800 plus trophy; 2nd Prize $200 plus trophy Powder Puff {Ladies only}: 1st Prize $500 plus trophy; 2nd Prize $150 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