Please Print & Fill Out Form and Return with Check / Money Order to the Following Address:

DIRT DUDS
ATT: NATHAN
621 FALLS RD.
MONTEREY, TN 38574

Please Make Checks/Money Orders Payable to: Dirt Duds

*** Please Allow 2-3 Weeks Delivery Time ***
NAME:(Please Print)______________________________________________________________
ADDRESS:______________________________________________________________________
CITY:________________________________________STATE_________ZIP:_______________
DAYTIME PHONE:________________________EVENING PHONE______________________
EMAIL ADDRESS:_______________________________________________________________

THE "DREAM" WEAVER SLAVIC T-SHIRT (BLACK)

DESCRIPTION PRICE QUANTITY TOTAL $
2010 The "Dream" Weaver Slavic T-Shirt (Black)      
Size Youth Large
 $15.00 each __________ __________
Size Small
 $20.00 each __________ __________
Size Medium
 $20.00 each __________ __________
Size Large
 $20.00 each __________ __________
Size XL
 $20.00 each __________ __________
Size 2XL
 $22.00 each __________ __________
Size 3XL
 $23.00 each __________ __________
Size 4XL
 $24.00 each __________ __________

THE "DREAM" WEAVER SLAVIC T-SHIRT (WHITE)

DESCRIPTION PRICE QUANTITY TOTAL $
2010 The "Dream" Weaver Slavic T-Shirt (White)      
Size Youth Large
 $15.00 each __________ __________
Size Small
 $20.00 each __________ __________
Size Medium
 $20.00 each __________ __________
Size Large
 $20.00 each __________ __________
Size XL
 $20.00 each __________ __________
Size 2XL
 $22.00 each __________ __________
Size 3XL
 $23.00 each __________ __________
Size 4XL
 $24.00 each __________ __________

#116 DREAM WEAVER T-SHIRT (WHITE)

DESCRIPTION PRICE QUANTITY TOTAL $
2010 #116 Dream Weaver T-Shirt (White)      
Size Small
 $15.00 each __________ __________
Size Medium
 $15.00 each __________ __________
Size Large
 $15.00 each __________ __________
Size XL
 $15.00 each __________ __________
Size 2XL
 $17.00 each __________ __________
Size 3XL
 $17.00 each __________ __________
Size 4XL
 $17.00 each __________ __________

#116 CAR AT GARAGE T-SHIRT (WHITE)

DESCRIPTION PRICE QUANTITY TOTAL $
2010 #116 Car at Garage T-Shirt (White)      
Size Small
 $15.00 each __________ __________
Size Medium
 $15.00 each __________ __________
Size Large
 $15.00 each __________ __________
Size XL
 $15.00 each __________ __________
Size 2XL
 $17.00 each __________ __________
Size 3XL
 $17.00 each __________ __________
Size 4XL
 $17.00 each __________ __________

#116 DREAM WEAVER LADIES T-SHIRT (WHITE)

DESCRIPTION PRICE QUANTITY TOTAL $
2010 #116 Dream Weaver Ladies T-Shirt (White)      
Size Small
 $15.00 each __________ __________
Size Medium
 $15.00 each __________ __________
Size Large
 $15.00 each __________ __________
Size XL
 $15.00 each __________ __________
Size 2XL
 $17.00 each __________ __________
Size 3XL
 $17.00 each __________ __________
Size 4XL
 $17.00 each __________ __________

WEAVER SPONSORS HOODIE WITH FRONT POCKETS (STONE WASH)

DESCRIPTION PRICE QUANTITY TOTAL $
2010 Weaver Sponsors Hoodie with Front Pockets (Stone Wash)      
Size Small
 $30.00 each __________ __________
Size Medium
 $30.00 each __________ __________
Size Large
 $30.00 each __________ __________
Size XL
 $30.00 each __________ __________
Size 2XL
 $32.00 each __________ __________
Size 3XL
 $32.00 each __________ __________
Size 4XL
 $32.00 each __________ __________

WEAVER LOGO HOODIE WITH FRONT POCKETS (STONE WASH)

DESCRIPTION PRICE QUANTITY TOTAL $
2010 Weaver Logo Hoodie with Front Pockets (Stone Wash)      
Size Small
 $30.00 each __________ __________
Size Medium
 $30.00 each __________ __________
Size Large
 $30.00 each __________ __________
Size XL
 $30.00 each __________ __________
Size 2XL
 $32.00 each __________ __________
Size 3XL
 $32.00 each __________ __________
Size 4XL
 $32.00 each __________ __________

LADIES ZIP-UP HOODIE W/ FRONT POCKETS & EMBROIDERED #116 (GRAY)

DESCRIPTION PRICE QUANTITY TOTAL $
2010 Ladies Zip-Up Hoodie w/ Front Pockets & Embroidered 116 (Gray)      
Size Small
 $30.00 each __________ __________
Size Medium
 $30.00 each __________ __________
Size Large
 $30.00 each __________ __________
Size XL
 $30.00 each __________ __________
Size 2XL
 $32.00 each __________ __________
Size 3XL
 $32.00 each __________ __________
Size 4XL
 $32.00 each __________ __________

LADIES HOODIE W/ FRONT POCKETS & EMBROIDERED #116 (GRAY)

DESCRIPTION PRICE QUANTITY TOTAL $
2010 Ladies Hoodie w/ Front Pockets & Embroidered 116 (Gray)      
Size Small
 $30.00 each __________ __________
Size Medium
 $30.00 each __________ __________
Size Large
 $30.00 each __________ __________
Size XL
 $30.00 each __________ __________
Size 2XL
 $32.00 each __________ __________
Size 3XL
 $32.00 each __________ __________
Size 4XL
 $32.00 each __________ __________

MENS ZIP-UP HOODIE W/ FRONT POCKETS & EMBROIDERED #116 (GRAY)

DESCRIPTION PRICE QUANTITY TOTAL $
2010 Mens Zip-Up Hoodie w/ Front Pockets & Embroidered 116 (Gray)      
Size Small
 $30.00 each __________ __________
Size Medium
 $30.00 each __________ __________
Size Large
 $30.00 each __________ __________
Size XL
 $30.00 each __________ __________
Size 2XL
 $32.00 each __________ __________
Size 3XL
 $32.00 each __________ __________
Size 4XL
 $32.00 each __________ __________

MENS HOODIE W/ FRONT POCKETS & EMBROIDERED #116 (GRAY)

DESCRIPTION PRICE QUANTITY TOTAL $
2010 Mens Hoodie w/ Front Pockets & Embroidered 116 (Gray)      
Size Small
 $30.00 each __________ __________
Size Medium
 $30.00 each __________ __________
Size Large
 $30.00 each __________ __________
Size XL
 $30.00 each __________ __________
Size 2XL
 $32.00 each __________ __________
Size 3XL
 $32.00 each __________ __________
Size 4XL
 $32.00 each __________ __________

#116 BEANIES (MENS & LADIES)

DESCRIPTION PRICE QUANTITY TOTAL $
Randy Weaver #116 Beanies (Mens & Ladies)      
Black Mens Beanie
 $16.00 each __________ __________
Blue Mens Beanie
 $16.00 each __________ __________
Brown Mens Beanie
 $16.00 each __________ __________
White Mens Beanie
 $16.00 each __________ __________
Gray Mens Beanie
 $16.00 each __________ __________
Black Ladies Beanie
 $16.00 each __________ __________
Blue Ladies Beanie
 $16.00 each __________ __________
Brown Ladies Beanie
 $16.00 each __________ __________
White Ladies Beanie
 $16.00 each __________ __________
Gray Ladies Beanie
 $16.00 each __________ __________

#116 SKULL BEANIES (MENS & LADIES)

DESCRIPTION PRICE QUANTITY TOTAL $
Randy Weaver #116 Skull Beanies (Mens & Ladies)      
Black Mens Skull Beanie
 $16.00 each __________ __________
Blue Mens Skull Beanie
 $16.00 each __________ __________
White Mens Skull Beanie
 $16.00 each __________ __________
Blue Ladies Skull Beanie
 $16.00 each __________ __________
Brown Ladies Skull Beanie
 $16.00 each __________ __________

VARIOUS RANDY WEAVER MERCHANDISE

DESCRIPTION PRICE QUANTITY TOTAL $
Various Randy Weaver Merchandise      
1:24 Scale 2010 Diecast Car (Black)
 $75.00 each __________ __________
1:24 Scale 2009 Diecast Car (Blue)
 $75.00 each __________ __________
Weaver #116 Mini-Mini Doors
 $10.00 each __________ __________
Pink #116 License Plate
 $10.00 each __________ __________
Green #116 License Plate
 $10.00 each __________ __________
3" x 5" Window Decal
 $7.00 each __________ __________
Weaver #116 Koozie
 $5.00 each __________ __________
#116 Golf Towel
 $13.00 each __________ __________

SHIPPING & HANDLING

Please Add $7.00 S&H to your Amount Totals
$7.00

GRAND TOTAL

Please Add all Total Amounts + Shipping & Handling __________
RANDY WEAVER RACING & DIRT DUDS ARE NOT RESPONSIBLE FOR LOST ORDERS OR MERCHANDISE. PLEASE SEND ONLY CHECKS OR MONEY ORDERS WITH YOUR PRINTED ORDER FORM. THANK YOU FOR YOUR SUPPORT OF RANDY WEAVER RACING!