Application for the First Annual
Ballston Spa Rolling Roadster's Race
To be held on August 12, 2000
(raindate August 13, 2000)
Name:___________________________________
Age: _____________
Address: _________________________________
Telephone Number: _________________________
Signature of Supervising Adult _________________
Emergency Contact (other than Supervising Adult)
Name: _________________________________
Address: ________________________________
Telephone Number: ___________________________
This application, the signed waivers and a five dollar ($5.00) day of race refundable fee must be received at Ballston Spa Village Offices, by close of business, July 21, 2000, 4:00 pm.
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