James Kimbrough Fan Club Membership Application

Thank you for your interest in joining the Official James Kimbrough Fan Club
Please complete this form and mail it along with a check or money order made payable to James Kimbrough to:
Kimbrough Motorsports
Attn: James Kimbrough
7518 Wilshire Road
Pensacola, FL. 32526

Please Print:
Name: __________________________________

Street Address: ___________________________

City: ___________________________________

State:___________________________________

Zip Code: _______________________________

Phone: _________________________________

E-mail: _________________________________

T- Shirt Size: (PLEASE NOTE: You may purchase up to 3 additional shirts for family members for only $8.00 each)

(Please indicate number of shirts next to size)
Youth: M______ L_______

Adult: S_______ M_______ L______ XL_______ XXL_______

YOUR NAME ON MY RACECAR!!!!

For an additional $5.00, your name can be on my race car for the Snowball Derby.
(PLEASE NOTE: Additional names for family members may also be purchased for $5.00 each)
Please Print:

NAME ON CAR:_________________________ NAME ON CAR:________________________

NAME ON CAR:_________________________ NAME ON CAR:________________________

TOTAL SHIRTS ORDERED:_____________
TOTAL NAME(S) on CAR:_______________
TOTAL AMOUNT ENCLOSED:____________

Thank you for joining and supporting the Official James Kimbrough Fan Club!