BC Place Democross February 4, 2012- Registration Form
Please fill out, print or just print then fill out and send

I am enclosing my non-refundable prepaid registration fee of $70 USD or $77 CDN for the following event:


Saturday Night - small cars democross (Arrival before 10AM)     


Deadline for $70 USD or $77 CDN entry fee (includes driver's pass, car entry, pitman pass and two stand passes) is January 16, 2012.
If you register after this date you may not get a shirt.


Please provide the following information so we may contact you if needed and supply the announcer with the information.

First Name:    Last Name:
Marital Status: Single Married      If married, spouses name
Children: Yes No    Ages(if applicable):
Address:




Phone number(s):
Email Address (if applicable):
Car Number 1st and 2nd choice:




Make money orders or cashiers checks payable to CMS and Return Entry Form To:
CMS
4227 S Meridian
Suite C, #161
Puyallup, WA 98373

Or in Canada to:

CMS
C/O Ross Edwards
3220 275A street
Aldergrove B.C.
V4W-3J5


Ross will forward the entries to CMS and if you have any questions in Canada about the show you may contact him at:

Ross Edwards
Home Phone:604*856*4095
Cell Phone:778*868*0472

Or in USA contact Mike Clark

253*861*6085



   T-shirt size: S M L XL XXL XXXL (XXL and XXXL more)

Additional T-shirt(s) size and quantity $15 USD or $17 CDN each (XXL XXXL $20 USD or $22 CDN):


Please enter any comments or additional information
you may not have been able to enter above: