White Dove of Hope Demolition Derby
Have Questions Call: Scoty Wilson 281-794-6514 - Mark Mills 936-346-7399 or  email:
Derby@WhiteDoveOfHope.org

CHAD TREICHEL MEMORIAL ARENA
30628 FM 1488 FIELD STORE, TX (Waller) FOR SATURDAY, April 26, 2008 (Please Print or Type)

Disclaimer: A demolition derby can be extremely dangerous to the participants and spectators. Participation in a demolition derby has inherent dangers that no amount of care, caution, or expertise can eliminate. If you are unable to evaluate all of the risks involved and you do not feel that you can be completely and solely responsible for your own safety.

I plan to enter the Demolition Derby to be held at the Chad Treichel Memorial Arena, on Saturday, April 26th, 2008. I am aware that I must check in with Derby Officials at the arena between the hours of 10am-3pm on the day of the Derby.

Any pictures, videos taken of myself, my car or persons affiliated with me, that are taken before, during or after competition, that are taken by White Dove of Hope staff, affiliates, participants and or any other person or persons becomes the property of White Dove of Hope. I agree and give my unlimited permission to White Dove of Hope to reproduce, print, display, advertise, video or sell any and all such media.

Driver Name / Pit Crew Member Name (Circle One}	Date of Birth	Drivers License		Telephone
Address	City		St		Zip
	Email :

Car Number

Year Model

Make

Sponsor	City	Telephone
If you have more Sponsor's, list them on the back of this form

I, the undersigned, have read the Entry Form, Release & Indemnification Agreement and official rules and thoroughly understand that I will enter the Demolition Derby under the stated conditions and will accept the decision of the judges and officials of White Dove of Hope as final.

Signature		Date

«     Entries will be received on a first come basis.  «  A non-refundable driver’s entry fee of $150 in advance.
($175 on the day of event) as well as a signed release form must accompany entry form
«                 Mail this form and checks / money orders payable to:

White Dove of Hope - Attn: DEMOLITION DERBY
P.O. Box 1716
Waller, TX 77484

* * * * * * Call 281-794-6514 to Pre-Enter (reserve you car number and spot). * * * * * *