Shrewsbury Volunteer Fire Department
Annual Race Pool

2014 ENTRY FORM

8 DRIVERS - NO MORE THAN $10,000

Please print

1. $
2.$
3.$
4.$
5.$
6.$
7.$
8.$
Total$

Please make sure we have your full mailing address.

NAME:
TEAM NAME:
ADDRESS:
PHONE:
E-MAIL:
USER NAME:
PASSWORD: (6 characters)
T-Shirt Size: SM M LG XL XXL (we will do our best to get the size you request)

Cost is a tax deductible $30.00 donation to the
Shrewsbury Volunteer Fire Department (SVFD).

Mail to:
Mark Stewart, SVFD
5246 VT RT 103
Cuttingsville, VT 05738

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