Viper Driving School S.C.C.A. Sacramento Chapter Mather Airport March 18, 2000 PRE-REGISTRATION IS REQUIRED!!!!! Fill in this form and mail  with entry fee  to: Candi Miller, Registrar;   8244 Longden Circle;   Citrus Heights,  CA 95610. FEES: $100.00 - Extra lunch tickets $5.00 ea. Make checks payable to S.C.C.A. Questions call: Ray Miller (916) 726-5833

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Name:
Address:
City/State/Zip:
Phone Nu	E-mail Address
Drivers Lic No.:	State
Emergency Contact  / Relationship?
at Event Site?	Phone #
Additional Driver:
Additional Drivers for the same car must submit separate completed forms (and fees) with that of the  primary driver. No more than two drivers per car.

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Car info: Year		Make
Model		Color

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Driver's Signature
Date