Dinner will be steak or chicken, baked potato with fixins, vegetables, salad, beverage and dessert.

Adult Dinner each         $   14.00     Children’s Dinner (12 and under)         $     6.00

Dinner tickets bought in VC       $    16.00                                                                   

NAME ___________________________________________________________

ADDRESS _______________________________________________________________________       

                        (NUMBER) (STREET)                   (CITY)            (STATE)  (ZIP CODE)      

PHONE NO.  _________________________                      

IF YOU BELONG TO A CLUB, PLEASE LIST NAME: __________________________ 

ADULT DINNER ea.   (Steak ___ Chicken ___)    $ 14.00   X   ____ = $   __________       

CHILD’S DINNER ea.                                                       $   6.00   X  ____  = $  __________     

Raffle Tickets $1 each, $5 for 6, $10 for 13, $20 for 28                            $ ___________

(Prizes include 3 ton jack stands, 4” angle grinder, 20’ tow strap, B & D drill set, Stanley 30’ tape, 22 piece wrench set, ½ drive electric impact wrench, diamond heart pendant, Motorola CB’s, Mr. Coffee, 600 watt microwave, TV/VCR combo.)

TOTAL                $______________

Please make checks out to Escarabajo Buggy Club and send to:

 2018 Truman Lane, Oakley, CA 94561

If you’re concerned you’re too late, call Treasurer Chris Dudley at 925-625-9354

or Rally Master Rick Mead at 925-827-3092.

Return by May 19^th, 2003.

                                                                                                                                                Internet Dinner registration form