Mid-South Hare Scrambles Series, Inc.  2007-2008 Awards Banquet
                            PRE REGISTRATION FORM

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        Pre-registration is REQUIRED to attend the Awards Banquet
                 PLEASE PRINT NEATLY. If we can't read it, 
                         we can't do much with it.
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                     ***  ONE FORM PER AWARD WINNER ***

 *** Admission is $28.00 PER PERSON 
     (infants in lap who will not occupy a chair are free)***.

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Rider/Attendee Information:

FIRST AND LAST Name ______________________________________________________


Contact Postal Address: __________________________________________________


Contact Telephone: (______)______-_________This is a Day___ or Night___ number.

Contact E-mail address: ___________________________________________________

Circle One:   [MCRider]   [ATV Rider]   [Youth Rider]   [Industry]

Rider's Class:____________________  MSHSS MEMBER Number: ___________________

Rider's Class Place: _____  and/or Overall Place: _______

Machine Brand:________ Model:______________ 

Number of this Season's Races Entered: _____

Total attendees including rider(s) and guests:________ 

Total Payment enclosed: $__________

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Attendees Guests:  First and Last name, ONE PER LINE

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Mail to: MSHSS, Inc. P.O. Box 944, Goodlettsville, TN 37070
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