BattleGang's "The Kickback" Round 3 Demolition Derby Registration Form - PayPal

BattleGang's "The Kickback" Round 3 Demolition Derby Registration Form - PayPal

Battlegang "The Kickback - Round 4" Registration

August 15, 2026 - 6 PM
Name

First NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birthday

MonthDayYear
Date
Phone Number:

Area CodePhone Number
Driver's License

StateNumber
E-mail
This is only the registration form.

Registration is $40 per car/driver; $20 is paid at the pit gate, and $20 is paid when you check in with your vehicle at the fairgrounds the day of the event. Registration for additional classes is $20 per class.

There is NO FEE for childrden to run in the Power Wheels classes.

Children ages 10 and under are free of charge to enter the pit at this show.
Class/Classes in which you are registering
STOCK POWER WHEELS NUMBER
Number
MODIFIED POWER WHEELS NUMBER
Number
BONE STOCK TRACTOR NUMBER
Number
PRO STOCK TRACTOR NUMBER
Number
INTIMIDATION TRACTOR NUMBER
Number
MWFA NUMBER
Number
4&6 CYL CHAIN & BANG NUMBER
Number
6&8 SWAP STOCK NUMBER
Number
INTIMIDATION CLASS NUMBER
Number
Should be Empty: