ADDRESS: ____________________________________________________________________

CITY: _____________________________________ ST:__________ ZIP:___________________

METHOD OF PAYMENT: Cash, Check, Money Order, Credit Card
AMOUNT: $_________________

CREDIT CARD NO: ____________________________________________exp.______________

TRACK:
CANANDAIGUA SPEEDWAY                                                RESERVED SEAT
Adult                      $225________                                         Yes ____ No _____
Sr. Cit/Student        $165________                                         Sec ____ Row _____ Seat ____
Parking Pass          $50 _________                                       Midway Park: Yes ____ No ____

CAYUGA COUNTY FAIR SPEEDWAY
Adult                     $195________
Sr. Cit/Student       $140________

ROLLING WHEELS RACEWAY PARK                                  RESERVED SEAT
Adult                     $185________                                         Yes _____ No ______
Sr. Cit/Student       $160________                                         Sec _____ Row _____ Seat____
DRIVE IN               $100________                                         Drive in # __________________

ALL THREE TRACKS
Adult                    $475________
Sr. Cit/Student      $335________

Child - 12 & Under Free to G.A.
Students: 13 - 16 Years Old                                    Senior Citizen: 60+ Years Old

Deposit Paid on __________________ Amount of Deposit ____________ Balance Due _______
Paid in Full ________________________ Pass Sent out On ____________________________
Comments: ____________________________________________________________________