Fantasy Racein League 2012 Sign Up

Please fill out all information and mail back, along with check for $50.00. All teams and money must be in by February 19th, 2012.
No team will be accepted without payment, no exceptions.

Please make sure that you read and understand all the rules before submiting your entry, Thank you

Payable To:

Roy Wurgley

110 Village Lane

Philadelphia, Pa. 19154

Driver Selections

Group 1

Group 2

Group 3

Group 4

Group 5

Group 6

Team Informatiom

Name

Address

City, State, Zip

Phone

E-Mail

Your Team Name

Print this page and mail back with your check

You Must Be 21 Years of Age To Join