PMC Logo
2015 AMA

Hillclimb

Grand Championship

Entry Form
AMA Logo
 

Name
Age/Birthdate
Address
AMA#
Exp. Date
City, State
Phone Number
Zip Code
Email
Select up to 4 classes (3 classes for youth riders) you wish to enter ($50.00 per class):
Bike Brand Class Bike Brand Class
Micro Mini
Open
65
Senior
Mini Junior
Super Senior
Mini Senior
Women
Mini Girls
400 Stock
Super Mini
Open Stock
125
4 Stroke
200
ATV 450 2 STK
250
ATV 450 4 STK
450
ATV Open 2 STK
600
ATV Open 4 STK
750
ATV Senior

Sponsors

 
                         Total length of your tow vehicle and trailer (If you are riding with someone enter 0):
                                                                      

Competitors get free weekend passes - additional gate passes are available for non-competitors for $20
for the weekend (children 5 and under are free). On-site camping (for competitors and their families only) is available
for $50 per vehicle - gates open at 6:00AM on Friday and all vehicles must be gone by noon on Monday.

Number of additional weekend gate passes ($20 each)
Number of vehicles camping ($50 each))

Event t-shirts and programs are available for pre-purchase at a discounted rate. T-shirts are $15 each ($20
on-site) for any size - indicate quanity of each size described below.
On-site quanities will be limited and will likely run out during the weekend.
Programs are $3 each ($5 on-site). Can coolers are for ($1 each).


ADULT
Small
Medium
Large
XL
XXL
Total

# of Programs # of Can Coolers

Enclose a check or money order (do not send cash) for $50 per class entered plus noted fees for other items.
Make checks/money orders payable to Pioneer Motorcycle Club and return with this completed form (and youth
birth certificates & minor release forms, if applicable) postmarked by July 7, 2015 to:


Pioneer Motorcycle Club
c/o Rick Ralston
1080 BF Goodrich Road
Marietta, Ohio 45750


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