Hustle Form

7th Annual Hillbilly Hustle Entry form

$125 entry fee

Ages 15 & up Raptor 370

Drivers Name:_______________________

Address:___________________________

City,State,Zip:________________________

Phone Number( )____________________

E-Mail:____________________________

Kart #____________________________

Chassis:____________________________

Engine builder:_________________________

Sponsors:____________________________

_________________________________

Make Checks Payable to Lake Village Motor Speedway

Mail this form and payment to:

Lake Village Motor Speedway

7437 N. U.S. Hwy 41

Lake Village, IN. 46349

Questions? Call the track at (219) 992-9529