Drive Name: ____________________________________________

Address: _________________________________________________

City/State: _______________________________  Zip Code: ___________

 WUMPA Truck Pull Registration                   Class_____________

 

Vehicle Information

Make, Model & Year____________________________________________

Sponsors: _______________________________________________________

__________________________________________________________________

 

I agree to abide by the rules and accept the Judge’s decision, and acknowledge that I am responsible for myself, my actions, and my vehicle, during competition.

 

Driver Signature________________________________ Date___________

This form need to be post marked 7 days before the Pull along with the entry fee of $20.00.

Send to Gary Chartier N4393 HWY 180 Marinette WI 54143