Please print, complete, and submit this form.

PACE CAR CONTEST
REGISTRATION FORM
Deadline for registration is May 1, 2008

Date___/___/_____

Name________________________________________Phone#__________________

Address______________________________________________________________

City_______________________________State_________Zipcode_______________

eMail address (optional)__________________________________________________

Church_______________________________________________________________

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please check all that apply:

_____ RA Leader
_____Challenger Leader
_____Parent
_____Other Adult

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Please mail this form and the minimum $10.00 offering, with a picture(s) of your completed Pace Car Kit to:

Royal Racers Pace Car
192 Lovejoy Rd.
Sparta, TN 38583

Registration MUST be RECEIVED in our office by May 1, 2008
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I hereby grant permission to Make Tracks Company / Royal Racers to use the picture(s)
of my completed Pace Car Kit in displays and advertisements for the National Race for
World Hunger.

Signature_____________________________________Date_____/_____/______