
PREMIERE RACING HOME | KEY WEST 2005 | SHORESIDE
BOAT NAME: ____________________________________________
ENTRANT NAME: _______________________________________
Number of Access Cards ______ x $54.00 = ____________ (Includes FL sales tax)
______ Check enclosed (Payable to Premiere Racing, Inc.)
______ Credit Card (information below)
Card Number: ____________________________ Expiration Date: _____________
Cardholder Name: _______________________________________________________
Cardholder Signature: ____________________________________________________
Contact Phone Number: ________________________
Mail to: Premiere Racing, Inc. Fax to: 781-639-9171
67B Front Street Questions?
PO Box 1067 Call: 781-639- 9545
Marblehead, MA 01945 Email: KWInfo@Premiere-Racing.com
PREMIERE RACING HOME | KEY WEST 2005 | CONTACT US