FREE T-SHIRT IF YOU REGISTER BY JULY 27.  T-SHIRT SIZE______

NAME__________________________________________AGE _______ MAKE OF BIKE___________

ADDRESS ____________________________________________________ # ON BIKE_____________

CITY __________________________________________STATE ___________ ZIP ________________

PHONE# _____________________________DEPARTMENT __________________________________

EMAIL ______________________________________________________________________________

 Indiana Fire & Police MX

  Mail to:  748 Memory Lane Hobart, IN  46342

   FIRST CLASS $30.00 EACH DAY, 1st ADDITIONAL CLASS $20.00 EACH DAY 

   3rd ADDITIONAL CLASS $10 EACH DAY

FIRE, POLICE & EMS CLASSES

DAY 1

DAY 2

____OPEN D

____Lites Novice

____MX Novice

____Lites Intermediate

____MX Intermediate

____Lites Expert

____MX Expert

____+30 

____+30 Novice

____+40 

____+40 Novice

____+50

____BEGINNER BIKE

____WOMEN

____QUAD A/B

____QUAD C

____QUAD OPEN

____CLYDESDALE +225

____50CC

____65CC

____85CC

____FIRST BIKE BEG KIDS

____SCHOOLBOY 

____MINI QUAD

____OPEN D

____Lites Novice

____MX Novice

____Lites Intermediate

____MX Intermediate

____Lites Expert

____MX Expert

____+30 

____+30 Novice

____+40

____+40 Novice

____+50

____BEGINNER BIKE

____WOMEN

____QUAD A/B

____QUAD C

____QUAD OPEN

____CLYDESDALE +225

____50CC

____65CC

____85CC

____FIRST BIKE BEG. KIDS

____SCHOOLBOY

____MINI QUAD

 PUBLIC SUPPORT CLASSES

DAY1

DAY 2

____Lites Novice

____MX Novice

____Lites Intermediate

____MX Intermediate

____Lites Expert

____MX Expert

____OPEN

____+25

____+30

____+40

____QUAD A/B

____QUAD C

____QUAD OPEN

____50CC

____65CC

____85CC

____SCHOOLBOY

____MINI QUAD

____Lites Novice

____MX Novice

____Lites Intermediate

____MX Intermediate

____Lites Expert

____MX Expert

____OPEN

____+25

____+30

____+40

____QUAD A/B

____QUAD C

____QUAD OPEN

____50CC

____65CC

____85CC

____SCHOOLBOY

____MINI QUAD

OPEN CLASSES

DAY1

____UTILITY QUAD

____DUAL SPORT BIKE

___PIT BIKE

____SUPERMINI

____OPEN BIKE $40 Entry

        80% CASH PAYOUT

____OPEN QUAD $40 Entry

        80% CASH PAYOUT

DAY 2

____UTILITY QUAD

____DUAL SPORT BIKE

___PIT BIKE

____SUPERMINI

____OPEN BIKE $40 Entry

        80% CASH PAYOUT

____OPEN QUAD $40 Entry

        80% CASH PAYOUT

Total Day 1  $__________   +  Total Day 2 $__________  =   Total Paid $__________