Enrollment Form

Office Use____________

MX Trainer Enrollment Form Pay Method__________

First Name________________________ Last________________________________

Address______________________________________________________________

City___________________________________State__________________________

Phone Number_________________________Emergency#______________________

E-Mail______________________________________________________________

Check Level A____B____C____D_____ How Many Years Experience___________

Check one 85_____125_____250_____ 450_____Bike Brand _________________

Lodging -RV_____ Bunkhouse_____ Age_______

Enrollment Fee is $350 meals & lodging are included. There will be a $100 Non-Refundable

Deposit to Reserve your spot. But you'd better Hurry this Camp will fill up Fast.

Send Deposit To 800 Motocross Park

6550 Crofton Fruithill Rd

Crofton Ky 42217