Please Print & Fill Out Form and Return with a Check or Money Order to the Following Address:
Justin Rattliff Racing
122 Cambridge Way
Campbellsville, KY 42718
Please Write Checks Payable to: Justin Rattliff
| NAME:(Please Print)______________________________________________________________ |
| ADDRESS:______________________________________________________________________ |
| CITY:________________________________________STATE_________ZIP:_______________ |
| DAYTIME PHONE:________________________EVENING PHONE______________________ |
| EMAIL ADDRESS:_______________________________________________________________ |
| DESCRIPTION | PRICE |
QUANTITY |
TOTAL |
| 2009 White "Rattler" T-Shirt | |||
Kids Size 14/16 |
$15.00 |
__________ |
__________ |
| Adult Size Small |
$20.00 |
__________ |
__________ |
| Adult Size Medium |
$20.00 |
__________ |
__________ |
Adult Size Large |
$20.00 |
__________ |
__________ |
| Adult Size XL |
$20.00 |
__________ |
__________ |
| Adult Size 2XL |
$20.00 |
__________ |
__________ |
| Adult Size 3XL |
$20.00 |
__________ |
__________ |
| DESCRIPTION | PRICE |
QUANTITY |
TOTAL |
| 2009 Black "Rattler" T-Shirt | |||
Kids Size 14/16 |
$15.00 |
__________ |
__________ |
| Adult Size Small |
$20.00 |
__________ |
__________ |
| Adult Size Medium |
$20.00 |
__________ |
__________ |
Adult Size Large |
$20.00 |
__________ |
__________ |
| Adult Size XL |
$20.00 |
__________ |
__________ |
| Adult Size 2XL |
$20.00 |
__________ |
__________ |
| Adult Size 3XL |
$20.00 |
__________ |
__________ |
| Please Add $5.00 S&H to your Amount Totals | $5.00 |
| Please Add all Total Amounts + Shipping & Handling | __________ |