------ HEAD TAX ------

Name of Ski Area:    _________________________________________________
Race Dates:  ________________________________________________________

Race Date_____________No. of Starters________x$5.00= $______

Race Date_____________No. of Starters________x$5.00= $______

Race Date_____________No. of Starters________x$5.00= $______

Total HEAD TAX Fees for the Race Series              $______

------ LATE ENTRY FEES ------

Total Collected $__________   1/2 payable to Masters $_______

Racers who must cancel their entries and notify you (race dept.) at least the day before the event starts are not to be charged.  Please tear up their checks.

Total HEAD TAX & LATE ENTRY FEES           $________

Please make check payable to: MASTERS SERIES SKI RACING and

 mail with this form to:

                                    Far West Masters Ski Racing                     

                                    PO Box 505

                                    Verdi, NV  89439