TERRA NOVA TRADING KEY WEST 2004, presented by Nautica

                                   Race Dates: January 19 - 23, 2004
                                   On Site Registration: Sunday January 18, 2004

MEDIA REGISTRATION

Name: 

Publication / Organization:

Title:

Mailing Address:

Email Address:

Web Site Address:

Business Phone:

Alternate Phone:

Fax Number:

Primary Media:
____ Periodical      ____ Newspaper      _____ OTHER __________________ 
____ Television      ____ Radio
____ Internet Site - URL: ___________________


Please indicate your preference for receiving Press Releases and Results:
____ Email (to the above email address)
____ Regular Mail (to the above address) 
____ Direct Access through www.Premiere-Racing.com

Please check one
___ I will attend Terra Nova Trading Key West 2004
___ I can not attend 
___ I am not yet sure if I will attend

Additional Comments or Questions:

Press Email: KWPR@Premiere-Racing.com
Rich Roberts: mailto:RichSail@earthlink.net


Event Email: KWInfo@Premiere-Racing.com
PREMIERE RACING, Inc.
67B Front Street
Marblehead, MA, 01945
Tel: (781) 639-9545, Fax: (781) 639-9171