PASS
SOUTHERN SUPER LATE MODEL SERIES
OFFICIAL ENTRY FORM - 2006
HICKORY MOTOR SPEEDWAY 150
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Track: Hickory Motor Speedway Race Date: Saturday April 15, 2006
Location: Hickory, North CarolinaRaces Start: Time trials @ 5 pm races @ 7 pm
Division: Pro-All Star Series/Registration: Gates Open 10 am, Tech 10:30 am
Super Late Model OpenPractice: TBA
Distance: 150 Laps Driver Meeting: 4 pm (Mandatory)
Promoter: PASS
Posted Awards: $22,375SPEC FUEL: SUNOCO RACE FUEL ONLY
Eligible products: SUNOCO “Standard” or “Supreme”
Must pass fuel test. *Fuel Policy to be confirmed by 4/1*
$22,375Promoter’s Purse Distribution
1st $5,000; 2nd $2,300; 3rd $1,300; 4th $1,100; 5th $1,000; 6th $800; 7th $750; 8th $650; 9th $600; 10th $575; 11th $550; 12th $525; 13th $500; 14th $475;
15th $450; 16th $450; 17th $450; 18th $450; 19th $450; 20th $450; 21st $450; 22nd $450; 23rd $450; 24th $450; 25th $450; 26th $450; 27th $450; 28th $450;
*(THIS PURSE GUARANTEED WITH SPEC FUEL)*
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ENTRY AND ADVERTISING RELEASE: The undersigned understands and agrees that their name and likeness may be used by P.A.S.S. to promote this event. The undersigned also understands and agrees that all decisions made by P.A.S.S. Officials shall be final and without recourse. In the event that this application is terminated, it shall be without restitution of any part of the fee paid in connection with this entry and further, waives any and all rights or claims to any bonus money due to resulting from racing efforts with P.A.S.S. prior to P.A.S.S. termination. The undersigned further waives any and all rights for themselves, their agents and assigns, to institute any action, suits or proceeding, whether at law, or any other action against P.A.S.S. and it’s officers, directors, agents and employees for any and all, manner or action and actions, cause and causes of actions, suits, damages, and claims that the undersigned and their heirs, successors, assigns may have not, or at any time in the future may have, arising in any manner of P.A.S.S. promoted events, excepting P.A.S.S. obligation to pay purses, bonuses, and awards as set forth in the official entry blanks for P.A.S.S. promoted events. The undersigned understands and agrees that this release constitutes a waiver of any and all claims for personal injury, breach of contract, and any other loss of damage except as expressly provided herein.
Driver: ______
Pay check to: ______Social Security # ______
Address: ______City ______State _____ Zip ______
Phone ______Owner: ______
Car Info:Make ______Model ______Year ______
Primary Sponsor ______Car # ______
Driver Signature ______Date______
Additional Event Information:
Qualifying Procedure: 26 cars will qualify for the feature event, the top 8 through time trials, the balance through qualifying heats and consolation races. There will be 2 provisionals that are the highest qualifying licensed drivers if needed. There will be 2 provisionals from the North based on highest points from 2005 season, if needed. The promoters reserve the right to add additional starting positions.
Entry Fee: P.A.S.S. Licensed Drivers: early registration = $100 late registration = $125
Non-licensed Drivers: early registration = $125; late registration = $150
Make Checks payable to P.A.S.S. US Dollars Only. EARLY REGISTRATION = POST MARKED BY APRIL 1, 2006
COMPLETE THIS ENTRY BLANK AND RETURN TO: PASS RACING, INC. – 195 LAKEHOUSE RD, NAPLES ME 04055
NOTE: Attendance at Driver’s Meeting is MANDATORY.
NOTE: Certain contingency and or bonus awards require usage of that product and display of sticker during this event in order to receive payment. Some contingency and or bonus awards will be paid directly by the provider. P.A.S.S. cannot assure timely payment for contingency or bonus awards.