Document 6608607

DISTRICT 14 MX BANQUET
SATURDAY January 17th, 2015
Best Western Sterling Inn & Waterpark
34911 Van Dyke Avenue Sterling Heights, MI 48312
(586) 979-1400
Doors open at 5:00pm Dinner at 6:00pm
Sorry NO tickets will be sold at the door.
YOU MUST PURCHASE A TICKET TO PARTICIPATE IN ANY PART OF THE BANQUET!
Information must be postmarked NO LATER than December 20th, 2014
Make checks payable to: District 14 MX
NAME____________________________________________________________________
ADDRESS__________________________________________________________________
CITY______________________________STATE________________ZIP________________
PHONE________________________Email_______________________________________
TICKETS
Name____________________________
Adult (11yrs & Up) Child (4-10)
$30
$20
Quantity
Quantity
________
________
Child (0-3)
Free
Quantity
________
Name____________________________
________
________
________
Name____________________________
________
________
________
Name____________________________
________
________
Please attach a separate sheet for additional names
________
Total Tickets_________x$30= _________
________ x$20= _________
Total Enclosed
$ ____________
JACKET INFO
Rider Name_________________________________________________________
Class#1___________________________ Jacket Size__________________
Class #2___________________________ Jacket Size__________________
Class #3___________________________ Jacket Size__________________
Youth:
Small (6-8)= YS
Medium (10-12)= YM
Large (14-16)= YL
X-Large (18-20)= YXL
Adult:
Small= AS
Medium= AM
Large= AL
X Large= AXL
XX Large= A2XL
st
Please note we will print 1 names on jacket ONLY. Last name and/or racing number can be added at
an additional fee of $5.00 per name or number.
PLEASE MAIL FORM TO:
Baja Acres
8683 Birch Run Road
Millington, MI 48746
Any questions please contact Baja Acres (989)871-3356