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Owner Name:
Owner Address: State: ZIP:
Contact Phone #:
Email Address:
Company Name:
Company Address:
Boat Manufacturer:
Model:
Year:
Boat Name:
Length:
Engine Manufacturer:
Engine Size:
Number of Engines:
Drive Type:
Top Speed (estimate):
Boat Sponsorships (if applicable):
Race Boat: YES NO
I will require the following SUPPORT.
[ ] Racing fuel Grade: [ ]100 [ ]116 # Of Gallons _______ (Must reserve by April 25.)
[ ] Crane Launching (Must supply your own slings and tag lines)
Insurance Policy Holder: ________________________________
Policy Number: ________________________________
Policy Expiration: ____________________
I have read, understand, and agree to abide by all Texas Outlaw Challenge Event Rules & Regulations.
Signature:________________________ Print Name:_________________________ Date: / /
(You may enter more than one class, as well as the Gambler Poker Run.)
RADAR RUN CLASS Entry Fee
[ ] Manufacturer Team Showdown $500
[ ] State Team Challenge (State Represented_______) $500
[ ] Sharp Shooter (MPH Class Entered_____) $250
(For the Sharp Shooter Class, please indicate MPH Class entered)
Circle a MPH Class: 75 80 90 100 110 120
[ ] Bounty Hunter $500
OSSSC CAT CL V VL CX VX TX
(For the Bounty Hunter Class, please circle the Class type entered)
[ ] Big Gun Fight $1,000
CLASS FEES (Subtotal) (Includes 1 DRIVER, VIP Event Armband) = $_______A
ADDITIONAL Radar Run Event Crew:
CREW Event Arm Band Includes:
- Admission to OUTLAW Pre-Party (Thursday Night)
- Admission to Gambler Run BBQ Lunch (Friday)
- Admission to OUTLAW Awards Banquet (Saturday Night)
- Free Access to VIP Spectator Viewing Park
- Free Access to VIP Bay Front Viewing Balcony (Babins Bar)
- Free Observation Tower Viewing
- Free Unlimited Water Taxi Service (Thursday & Friday Night)
# of Crew Members____ x $100 per person = $_______B
GAMBLER POKER RUN
Captain: Includes (3-Card Stud hand and lunch) = $_______C
Additional Hands ($100 per hand)
# of extra 3-Card Stud hands ______ x $100 = $_______D
Additional Poker Run Crew Armband (access limited to Poker Run & Lunch )
# of Crew _____ x $50 per person = $_______E
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PAYMENT
Please enter myself and crew in the Event activities checked above.
I understand the total cost is A+B+C+D+E = $ __________.00
Payment Method
[ ] CASH [ ] CHECK #________ [ ] MONEY ORDER # __________
Please make payment to: Texas Outlaw Challenge P.O. Box 580388 Houston TX 77258
[ ] CREDIT CARD: Type________ Card #_________________________ Expiration Date:__________
I authorized the use of my credit card for this transaction.
SIGNATURE: _____________________________________ DATE:________________
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