PRE- REGISTRATION FORM

 

PRE-REGISTRATION MUST BE RECEIVED BY MARCH 15, 2010

MAIL TO: MULESHOE ROADRIDERS PO BOX 275 MULESHOE TX 79347

 

 

DRIVER:___________________________________________________________

 

ADDRESS:__________________________________CITY/ST/ZIP_____________

 

PASSENGER:________________________________________________________

 

ADDRESS:__________________________________CITY/ST/ZIP_____________

 

PHONE:_______________________ AMOUNT ENCLOSED:_________________

 

 

I, THE UNDERSIGNED, AGREE NOT TO HOLD THE M.R.R. OR IT’S ASSOCIATES RESPONSIBLE FOR ANY INJURIES TO MYSELF OR PASSENGER, OR DAMAGES TO VEHICLES OR EQUIPMENT, BEFORE, DURING OR AFTER THE RALLY.

 

 

SIGNED:___________________________________________________________

 

DATE:_____________________________________

 

DRIVER TMRA/AMA NUMBER__________________________________________

 

PASSENGER TMRA/AMA NUMBER_____________________________________