2013 Keystone Nationals Truck & Tractor Pull

2013 KEYSTONE NATIONALS TRUCK & TRACTOR PULL

PLEASE RETURN THIS WHOLE APPLICATION AS SOON AS POSSIBLE

PULLER INFORMATION

Name:

Address:

City, State:

Phone Number:

E-mail Address:

VEHICLE INFORMATION

Make/Model:

Vehicle Name:

CHOOSE YOUR CLASS OF COMPETITION

ONLY CHOOSE 1 CLASS PLEASE

9,300 Super Farm

10,000 Pro Farm

9,500 Super Stock/10,000 Pro Stock

8,500 Mod Turbo/Limited Pro

6,200 Pro Mod 4X4

7,800 Modifieds – ITTP Rules

8,200 Limited Super Stock/8,500 Light Pro Stock*

6,200 Modified 2 Wheel Drive

ITTPA Modified Mini Small Block

ITTPA Modified Mini Big Block ______

7,500 Light Limited Turbo

8,000 Diesel 4X4 Trucks

4,000 Small Block 4X4

6,200 Alcohol Super Stock ______

* 8,200 Limited Super Stock will follow ITTP Rules and 8,500 Light Pro Stock will follow NTPA rules.

PAYMENT INFORMATION

Entry Fee - $150.00 per vehicle postmarked on or before January 31, 2013 and $180.00 FOR APPLICATIONS POSTMARKED FROM FEBRUARY 1-11, 2013.

Make checks payable to: FRANKLIN COUNTY TRACTOR PULLERS

Send Payment and the application to: DESTINEE PALMER
19815 MILLBROOK ROAD

KEEDYSVILLE, MD 21756

ARMBAND INFORMATION

EACH PULLER WILL RECEIVE (2) HOT PASSES GOOD FOR THE DRIVER AND ONE TRACK HELPER.

ADDITIONAL ARMBANDS MAY BE PURCHASED.

(These will include access to pits and arena seating, but not track access)

Please indicate if you want one or two additional armbands beside the desired date.

(Example: 2 extra armbands for Thursday are 2 @ $20 = $40.00)

Thursday March 14, 2013 ($20ea.) Saturday March 16, 2013(All Day $50ea.)

Friday March 15, 2013 ($20ea.) All Weekend Passes ($60.00ea.)

PULLER PROFILE

(Please take time to fill this out for our announcers)

Name:

Address:

( City ) (State)

Vehicle Make/Model :

Name of Vehicle:

Occupation:

Hobbies other than pulling:

Recent Pulling Accomplishments: ______

WARRANT OF CLUTCH, FLYWHEEL & BELLHOUSING COMPONENTS

(Name of owner or driver)

(Street Address)

(City, State, & Zip Code)

THE UNDERSIGNED GUARANTEE THAT MY COMPETITION VEHICLE, DESCRIBED AS FOLLOWS

(Year, Type or Model)

(Vehicle Name)

is currently equipped and will be continually equipped with all clutch assembly, flywheel, and bellhousing components, that are equal to or exceed the minimum safety requirements as defined in your class rules, while participating at the Keystone Nationals event. The flywheel, clutch, and pressure plate components on competition vehicle must be made of steel, aluminum, or ductile iron. Positively no gray cast iron allowed. This guarantee of compliance with all clutch, flywheel, and bellhousing components.

Signature of Owner or DriverDate

State of

County of

Signed in my presence and sworn before me this day of , 20

Notary Public

Expiration