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									                        BMS NATIONAL OPEN 2012
                          Event Pre–Entry Form
                                                 PLEASE TYPE OR PRINT CLEARLY

NAME _______________________________________________________________________________________

Home Phone____________________ Cell #______________________ Email_______________________________

Event Date __________________________

Entry $35.00 per regular Money class.

Entry $100 for UAS rules class with Burris Tire rule

Entry $175.00 for $10,050 to win Animal 375

SATURDAY CLASSES

Class# _____ Animal 375 Class __________________________________________Kart #___________Second Choice________

Class# _____ UAS Money Class __________________________________________Kart #___________ Second Choice________

Class# _____ Regular Money Class _______________________________________Kart # ___________ Second Choice________

Class #______Regular Money Class_______________________________________ Kart #___________ Second Choice________

Class# _____ Regular Money Class________________________________________ Kart #___________ Second Choice_______
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Class# _____ Regular Money Class________________________________________ Kart #___________ Second Choice________

SUNDAY CLASSES

Class# _____ Regular Money Class _______________________________________ Kart #___________ Second Choice________

Class# _____ Regular Money Class ________________________________________Kart #___________ Second Choice________

Class# _____ Regular Money Class ________________________________________Kart #___________ Second Choice________

Class# _____ Regular Money Class ________________________________________Kart #___________ Second Choice________


# of Regular Money Class Entries x    $35.00      __________________________

UAS Money Class Entries x - $100.00           _______________________________

Animal 375 class Entry- $175.00           ________________________________


]Total Amount Enclosed            _________________________________


Make Checks Payable to:      Keith Blumenstein          Please place in memo space BMS National OPEN

Questions regarding pre-entry addressed to:
Keith Blumenstein @ BMSevent@aol.com


                   Please mail completed forms to:        Keith Blumenstein
                                                          509 Bonners Hill Road
                                                          York Springs, PA 17372

								
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