Click on printer icon to the right to print form, fill in & mail with check to address below.
LAKE
GARNETT ROAD RACE ENTRY FORM
NAME_________________________________ Age_____ Date of
Birth____/____/____
Address_______________________________ City_______________
State_______ Zip________
Phone # (______)_______-__________ Kart Membership
#______________________ Exp._____
Date of Race _____________________
Class Name_______________________________ Kart#_______________ Transponder # _____________
Class
Name________________________________ Kart#_______________ Transponder # ______________
Class
Name________________________________ Kart#_______________ Transponder # ______________
Class Name________________________________ Kart#_______________ Transponder # ______________
Class Entry
______@ $70.00= $_____
Tag Cadet Entry
______@ $40.00= $_____
Transponder Rental______@ $10.00= $_____
TOTAL $________
Signature
(18 or older) _______________________________
Print
Signature Name_________________________________
MAKE
PAYMENT TO GARNETT KART CLUB - mail to Ron Anderegg at 1581 South Maple St. Garnett, KS 66032
Passes:
Pay at Track
Driver - $25
Non Driver 12 & up - $20
Non Driver 2-11 - $10
For information call Ron at 785-448-3589 or 785-448-4537 or
785-448-6366.
Brand new Hotel - Garnett Inn
785-448-6800
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