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SATURDAY
" 9:00 STAR T
100 · CLASSIF IED . A LL
125 · C LASSIFIED. ALL
175 · CLA SSIFIED, ALL
WOMEN CLASS . A LL
MAIL ENTRY TO :
GREAT BEAR GRAND PR IX
280 5 SAN JUAN LAN E
COSTA MESA CA LIFORN IA
926 26
PHONE : 1
7141556-77 27
SA,URDAY
~AMA
!i
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DO NO T WRITE
IN TH IS SPACE
G.P. No.
DISTR ICT 37·38
FOR DISTRICT 3 7-3 8 POINTS ONLY
CLASS IF ICAT IO N
WESTERN
UNITED STATES CHAMP IONSHIP
D ISTRI CT 37 NO.
NOVI CE
DISTR ICT 38 NO.
JUNI O R
-
IIl11II'l:JCl6T ASSQCIA1I(1f
BEGI NNER
DIV ISIO N
EXPERT
CHECK~
OT HER "
CLUB
- IF YOU DO NOT H AVE A C U R RE NT DISTR ICT Jl.3I C A R D: ATTACH
COpy OF CLASS IFICATI ON FROM O TH ER O R G AN IZ A T IO N .
Ma il Entry $1 9.00 a r ide r - Post Entry $35.00
(Includes $ 1.00 for District 37 . 38 Legal Defense Fund )
ENTRY MUST BE ACCOMPANIED BY 3 SELF-ADDRESSED, STAMPED, LEGAL SIZE ENVELOPES, PHOTOCOPY
1:00 START
OF RIDER CLASSIFICATION , AND AMA CA RD.
SPO RTSMEN ( A LL)
Name
Address
C;ty
MAI L ENTRY TO :
"
G R EAT BEAR GRAND PR IX
IPlea le P, inl Clear lv )
Age
Ste te
Eng. No.
Eng. £'ize
Zip
Make Bik e
A MA
_
Phon e _ _-'/
Exp ires
#
_
_
ZJ5 N. MA LE NA DRIVE
ORANGE. CALIFORNIA 92669
PHONE : ( 714 1 53& 572 1
SUNDAY
9:00 START
250 · BEG . NOV. SR .
500 · BEG. NOV. SR.
OPFN ; BEG. NOV . SR.
MA IL ENTRY TO :
GREAT BEAR GRAND PRIX
16532 M A R I E LA NE
HUNT INGTON BEAC H,
CAL IFORNIA 92647
PHONE : (71 4 1 84&2146
THE U N D E RSI GN ED ENTRANT BY AFFI XING H IS IN IT I A L S BELOW, ACKNOW LE DGES THAT H E A SSUMES T HE RISK O F AN Y LO SS FROM
INJUR Y OR PROPERTY DAMAGE TO HIM SELF OR TO OTH ERS. DUE TO HIS PAR TIC IPAT ION IN THIS EV ENT AND HE HEAEW I TH SPECI F·
ICA LlY HOLDS HARMLE SS FROM ANY SAID LOSS THE AME RICAN MOTORCYC LE ASSOCIATION, SPORTS COMMI TT E&, OIST RICT 31138
AMA, I NC., THE , SPONSORING CLUB OR ORGAN IZ ATION, AND THE OWNERS OF TH E RE AL PROPERT Y ON WHICH SAID EVE NT SHA L L
TA KE PLACE .
The underSIgne d does hereb y cerllt y trU 11 "'. " .. duly Qu.lItied (Ci r Cle O ne) Ju n io r I EJI;pe rt I Nov ia I B eg i n n er c l.u motorcycle r id er h. v lng bMn SOQual·
i fled by .. co mpe te n t o r g a n ization.
It i, t u r t he r u nde rs t o od a n(! agr eed I h at In t he eve i'll I a m i nj u r e
