LAND OF LINCOLN SUPERMOTO SERIES

2009 ENTRY FORM

NAME______________________________________________________________________

ADDRESS____________________________________________________________________

CITY__________________________________________ STATE________ ZIP____________ 

PHONE____________________________________   COMPETITION NUMBER____________

EMERGENCY CONTACT________________________________    PHONE_________________

SIGN______________________________________________ DATE_____________________

MOTORCYCLE INFO:

MAKE:_____________________ MODEL:____________________ CC'S:________

CLASS (CHECK THE ONES YOU WISH TO RACE)

OPEN MONEY____ OPEN EXPERT___ _ OPEN AMATEUR__  _ VETERAN___  _ SPORTMOTO_  __   OPEN LITES___ _ SUPER PITBIKE___  _ YOUTH SUPER MINI_  ___ YOUTH JUNIOR MINI____

OPEN QUADS____

PRE-REGISTRATION: $40.00 FOR FIRST CLASS ($20.00 FOR YOUTH MINI) THEN $30.00 FOR EACH ADDITIONAL CLASS

DAY OF RACE REGISTRATION: $60.00 FOR FIRST CLASS ($25.00 FOR YOUTH MINI) THEN $30.00 FOR EACH ADDITIONAL CLASS

FREE PRIMITIVE CAMPING NIGHT BEFORE RACES

MAIL PRE-REGISTRATION FORM AND MAKE CHECKS PAYABLE TO:

LAND OF LINCOLN SUPERMOTO 

218 DERBY ST. PEKIN, IL. 61554

OR CALL 309-353-7223