REGIONAL KARTING CONNECTION MAGAZINE

Please Send $25.00 for 1-Year Home Delivery Service (shipping/handling).  Make Check payable to :  Gibbs Publishing .

Please check all that apply:  other_______________racer_______
Mfc.____retailer______track____Promoter_____Spect________

What track do you race most often?_______________________

Classes?_____________________________________________

Where did you hear about Regional Karting?_________________

Do You purchase from our sponsors?_______________________

Thank you, Tammie C. Gibbs Editor/Publisher

Name:

Address:

City:

State/Prov:

Country:

Zip/Post. code:

Phone:

E-mail:

Method of Payment

Credit Card #:

Exp. date:

Please Print this form out using your web browsers print button-then mail to:  Regional Karting Connection, 181 Trotters Lane, Vidalia, Ga. 30474.  Or Call 912-537-7308.