Pinewood Derby Proxy Racing Form

A proxy is someone who you let act on your behalf. In this case, someone who will handle your Pinewood Derby car and race it for you on January 25th, because you can't be there. Your proxy does not have to belong to your den or Pack 835.

To have a proxy race for you, follow these steps:

Build your Pinewood Derby car yourself.
Write your name in ink on the bottom of your car.
Complete and sign this form.
Give the form and the car to your proxy.
They must bring the car and form to Binkley Baptist Church at 9:30 AM on Saturday, January 25, 1997 to race for you. They must stay for the whole race.

First, who are you?

Second, who is your proxy?

Reminders:

Your car must still pass inspection to race.
If your car wins and is one of the nine finalists, we will keep it for the District Pinewood Derby.
District rules do not permit proxy racing.
Otherwise, your car and any prize you win will be given to your proxy. You must get it from them.
We cannot be responsible if your proxy breaks your car.
All rules of sportsmanship and behavior that apply to you apply to your proxy.