Bonus Race Entry Form

Ultimate Bonus Purchase Agreement Form
Contestant Name*

First NameLast Name
Contestant Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number*
Please enter a valid phone number.
Email (Please use same email used to login to SGP)*
example@example.com
Pay by check

If selected, payment must be mailed within 24 hours. Mail to Double B Productions P.O. Box 306 Checotah, OK 74426. There will be a $25 NSF fee for any insufficient funds.
Full Pay ($15 discount if paid by September 30)

Full payment of $1485 by check to be mailed within 24 hours of entry.
Pay by credit card

4% convenience fee included in each payment.

Payment Options

Full PaymentFull payment of $1500 less $15 discount if pad by September 30 ($1485). 4% convenience fee included in total. Price increases by $25/mo after September.

$1,544.40 one-time payment

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

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Ultimate Bonus Purchase Agreement Form

Pay by check

Pay by credit card