The RPM One Loft Race

Entry Form

		1/2		1/3		Total Due
		Perch Fee		Entry Fee		Per Bird
	Band Number	$50.00		$50.00		$100.00
1		$50.00	+	$50.00	=	$100.00
2			+		=
3			+		=
4			+		=
5			+		=
6			+		=
	Total Due:

Breeder Name:

Breeder Address:

Breeder Phone:

Breeder may enter from one (1) to six (6) birds in the race. No more than six birds will be allowed per breeder in the race series. Replacement birds require no additional fees.

Include $ 100.00 per bird entered ($50 perch fee + $50.00 entry fee)

Breeder will be invoiced after the 150-mile race to submit the remaining $50 perch fee and $100 entry fee per bird still remaining in the loft. These fees must be paid to activate bird for the 200-mile race. The $100 entry fee will be refunded if bird is not shipped to the 200-mile race.

Make checks payable to / and ship birds to:

John Vance

5020 Ferndale Rd

Ferndale, WA 98248

(360) 384-5701