2011 Special Olympic Indoor Benefit Race 
Harrisburg Farm Show Complex
December 4, 2011

Gates open at 6am, heats at 8am,   Rooms available at Holiday Inn Grantville, exit 28 off I81, 
717-469-0661   ask for Norlebco Racing rate
Pre-registration is available  Sat Dec 3, at the Holiday Inn Grantville




Drivers Name : ______________________________________  Drivers age : _____

Address : ______________________________ ____  City : _____________________

State : ___________  Zip : _________ Phone : _______________________________

Birth date : ________________   Home track : _____________  yrs racing _________




                           	Class  or classes					t shrit size
  				   							
___Honda Red (250)    		___ Jr Honda  (250)	                     ___ Ch medium       
___ Sr Honda (275)		___ Hvy Honda (325)**	                     ___ Ch large
___ Lt 160 ( 270)			___ Hvy 160 (325) **		    ___ Adult small
___  Lt  World Formula  (295)          ___ Jr Animal          		     ___ Adult Med
___ Hvy Wf ** (340)		___Half 	     			    ___ Adult Lg
___ Jr Stock (235)		___ Sr Stock (260)		     ___ Adult Xlg
    ** donates minimum drivers weight of 100 lbs                             1 tshirt per driver


	Additional T-shirts   $12.00   size _______ 2xlg add 1.00
                    Sweatshirts :   $28.00          size : ______  xlg or 2xlg add 2.00


   Car registration ~ $60.00 per car and 1 handler  Parking passes available at registration
*** 10 minute time limits on heats, 20 minutes limit on features, minimum ½ laps
No registrations will be accepted at the door, Deadline for Registration is October 28,
After deadline, please call for available spots..
T-shirt not guaranteed if late
No  refunds
Checks payable to Norlebco

Mail to : Johna Hitzler
873 Richard Drive   Lebanon, Pa 17046
For race information contact : Rich Hitzler 717-270-5487