Lyon County Fair  2012

                                                                 July 22, 23, 24, 25, 26

 PLEASE PRINT

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REGISTRATION FORM - MUST BE IN NO LATER THAN 1:00 P.M. JUNE 15, 2011 for the JUNE 18 RACE , 1:00 P.M. JULY 25, 2011 for the JULY 27 RACE .

Name of Driver________________________________

Phone Number_______________________

Make and Model of Car_____________________

Age of Driver_______Male_____Female____Car number assignment ____________

Entry fee paid by: Cash_______ Check____________

 

Registration for JUNE 18 RACE___________________ Remit $10.00

Registration for JULY 27 RACE ___________________ Remit $10.00

Please check which race you are entering.

                                                                        Total Enclosed_______________________

                                                                        Address____________________________

                                                                        City________________________________

                                                                        State_______________Zip_____________

Return to: Peggy Groves                                           

                Lyon Co. Fair Assn.                       

               1206 Buchanan Ave                                   

                Larchwood, IA 51241

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WOMEN ON WHEELS ENTRY

Name _____________________________________________

Address____________________________________________

City_______________________________________________

State ______________________Zip_____________________

Age______________________