SMASH BROS DEMOLITION REGISTRATION
OFFICIAL FORM
Age: Minimum age for Driver is 16 (with parent signature)
Name:
Your Age:
Address:
Phone No:
E-Mail:
Car Type:
Year:
Please circle one of the following:one category per form:
4 Cyl. Full demo
4 Cyl. Figure 8
4 Cyl. Demo Cross
Mini Van
Truck ¼
Truck ½
6 /8 Cyl. Full Demo
Sponsor:
Waiver/ Release: I hereby release Smash Bros and all members who are officially
associated with the organization of the demolition derby, including landowners, for any injuries,
accidents or damage whatsoever, arising from any participation in or resence at the event.
Entrant’s Signature:
Date:
Entry fee is $50.00 and we would ask that you pre-register due to limited space. Please forward
complete form to Bryan or Krista Taylor 11 Parkview Street Grand Valley, Ont. L9W 5W6. Any questions
contact Bryan or Krista at 1-519-928-5383 (evenings)