5th Annual

Rotary Teton Hillclimb

 

September 8-10, 2006

Grand Targhee Resort

Alta, Wyoming

Sanctioned by The Northwest Hillclimb Association

 

Entry Form

 

 

DRIVER and CAR INFORMATION:

DRIVER #1                                                 DRIVER #2

 

Name:   _______________________________        ______________________________

Address: _______________________________       _____________________________

City: __________________________________       _____________________________

State, Zip______________________________        ______________________________

Home Phone: ___________________________       ______________________________

Work Phone: ___________________________        _____________________________

Driver License#: ________________________        _____________________________

Car Club: ______________________________       _____________________________

Car Year/Model: ________________________        _____________________________

Displacement: __________________________        _____________________________

Color: _________________________________       _____________________________

Class: _________________________________        _____________________________

Car#: ___________ 2nd Choice_____________         _________2nd Choice___________

 

IN CASE OF EMERGENCY NOTIFY:

Name: ________________________________                      _______________________

Phone#: _______________________________                     _______________________

Relationship: ___________________________                      _______________________

Is this person at the hillclimb: ______________                      _______________________

 

FEES:

______Drivers @ $75 each……………………………………………...$___________

________Late fee (if postmarked after Aug. 29, 2006) $20 each………….$___________

________Drivers for 1 day only (Sat or Sun) @ $45 each………………...$___________

________Saturday dinner (all inclusive) @ $20..……………...….……….$___________

                 ________Kids (6-14) @ $12, Kids (under 6) free.……………..$___________

________ T Shirts @ $15, ____S, ____M, ____L, ____XL,____XXL…...$__________

 

TOTAL……………………………………………………………………..$___________

 

 

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Credit Card Payment:

 

Card type_________________________________________________

Card Number______________________________________________

Expiration Date____________________________________________

 

Signature_________________________________________________

Date_____________________________________________________

 

 

Mail Entry form to:

John Hansford

C/O Drawknife Billiards

516 N Hwy 33

Tetonia, Idaho 83452

208.456.2560 (day)

208.354.8975 (evenings)

208.351.1497 (cell)

 

E Mail form to:

John Hansford

hansford@drawknife.com

 

Make checks payable to:

Rotary Club of Teton Valley

 

VOLUNTEER COURSE WORKERS

 

Name: ______________________________Phone#: ________________Sat   Sun    Both

 

Name: ______________________________Phone#: ________________Sat   Sun    Both

 

Name: ______________________________Phone#: ________________Sat    Sun   Both

 

MEALS

Lunch will be available Saturday & Sunday at the Targhee Steakhouse.

Breakfast buffet will be available both Saturday & Sunday in the Targhee Steakhouse

for $9.95 (does not include taxes and gratuity)

 

LODGING

Rooms available at Grand Targhee for $69.00 (tax included),

Larger rooms available for extra cost.  All resort services will be available this year.

Call Grand Targhee Reservations 800.827.4433 and dial 0

Motorhomes and self-contained campers are welcome, but no hookups.

Campsites are available in Teton Canyon