SCRR East Division Derby Registration

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Saturday, March 15, 2025
First Assembly of God
1151 Alice Drive
Sumter, SC, 29150

Name
This person must enter their info below if entering a car.
Email
Yous should have the same number of cars entered below.

Enter the information below for each car you are registering, including the individual completing this form. Use the “+” to the right of the Age Group to add another car:

Car Owner
ER 18+ must register in Men and Women 18+.
Select the number of cars you are registering from the dropdown list to see the total due. These prices apply to the members of one family.
$0.00
I plan to pay with:
If paying with Credit Card, Google Pay or Cash App, contact Mark Sneider – royalranger17@gmail.com – for details.