2009 Heartland Challenge Entry Form
All Entrees must be submitted by email.
All Entrees must be complete and include digital photos of Team.

Contact Info:
Contact will me made before any registration is final.

Team Name	Class #	1. Pro 2. Pro Utility 3. Pro-Am 4. A 5. B 6. C 7. +30 8. +40 9. Industry 10. Woman 11. Schoolboy 12. Ironman 13. 90cc Production 14. 90cc Stock 15. 70cc 16. 50cc 17. Mini UTV 18. 700 Limited 19. 700 Modified 20. 850 Limited 21. 850 Modified 22. Open UTV
Contact Name	Address
Phone #	City
Cell #	State, Zip
Email	Payment		Check/M.O.	PayPal

Racer Info:

	First/Last	Home Town & State	Machine Brand	ATVA/AMA#	T-Shirt size	Birthday/Age/ Gender
Racer #1					S M L XL 2XL 3XL 4XL YS YM YL
Racer #2					S M L XL 2XL 3XL 4XL YS YM YL
Racer #3					S M L XL 2XL 3XL 4XL YS YM YL

Class/Registration Fees: Check Box by Class
Registration Fees paid by Check, Money Order or PayPal(Please add 3% for PayPal entries)

1. Pro - $500	13. 90cc Production - $150
2. Pro Utility - $500	14. 90cc Stock - $150
3. Pro-Am - $400	15. 70cc - $150
4. A - $250	16. 50cc - $150
5. B - $250
6. C - $250	17. Mini UTV - $50
7. +30 - $250
8. +40 - $250	18. 700 Limited - $150
9. Industry - $250	19. 700 Modified - $150
10. Women - $250	20. 850 Limited - $150
11. Schoolboy - $250	21. 850 Modified - $150
12. Ironman - $150	22. Open UTV - $150

Photos:

Please attach group photo or individual photos in digital format of at least 800x600
Entrees will not be accepted without photos & photos may be used for promotional purposes.

Sponsors/Accomplishments:
(Sponsors may be added or changed anytime by Email prior to registration close)

General Registration Info:

-Racing Number will be assigned only after entrees are completed and checked by race officials. -All info must be complete, confirmed and registration fee paid before entrees will be official. -Names, Photos, Sponsors and Home Towns will be posted on Web site/Advertising. -Contact Information will only be used by Race officials and will not be posted. -Please complete form and submit to: Registration@HeartlandChallenge.com -PayPal to Payment@HeartlandChallenge.com

Check or Money Order mailed to: Heartland Challenge 3472 S23 Hwy , Carlisle , IA 50047