Raceway Video Order Form

To pay by check or money order, print, fill out and mail in this order form.

Copies of individual race dates are $20 for VHS video tape or DVD. Either pick up a copy at the next event, or make checks payable to Jeff Kristensen and mail to the address below.

Race Date:______________ Track:_______________ Quantity:_____  Tape or DVD:________

Race Date:______________ Track:_______________ Quantity:_____  Tape or DVD:________  

Race Date:______________ Track:_______________ Quantity:_____  Tape or DVD:________  

Race Date:______________ Track:_______________ Quantity:_____  Tape or DVD:________

Race Date:______________ Track:_______________ Quantity:_____  Tape or DVD:________  

Race Date:______________ Track:_______________ Quantity:_____  Tape or DVD:________  

Total Enclosed: $___________ 
Please include $5 shipping/handling for orders of 1 - 5 tapes (add .50 for each additional tape)  

Order 10 or more and receive a 25% discount!!

Name:________________________________________________________________________

Address:______________________________________________________________________
 (No PO Boxes please - shipped via UPS Ground)  

             ______________________________________________________________________

Phone:___________________________  or  ___________________________

E-mail:_________________________________________________________

 Please make checks payable to Jeff Kristensen

10701 Burbank Blvd North Hollywood CA 91601    818.618.9764    racewayvdo@aol.com