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

Randy Weaver
c/o Randy Weaver Racing Apparel
699 Creekway Drive
Crossville, TN 38555

Please Make Checks/Money Orders Payable to: Randy Weaver

Please Allow 2-3 Weeks Delivery Time (Depending on Availability& Race Schedule)
NAME:(Please Print)______________________________________________________________
ADDRESS:______________________________________________________________________
CITY:________________________________________STATE_________ZIP:_______________
DAYTIME PHONE:________________________EVENING PHONE______________________
EMAIL ADDRESS:_______________________________________________________________

RANDY WEAVER #116 SHORT SLEEVE SHIRTS

DESCRIPTION PRICE QUANTITY TOTAL $
White Randy Weaver T-Shirts      
Adult Size Large
 $20.00 each __________ __________
Adult Size XL
 $20.00 each __________ __________

RANDY WEAVER #116 WINDOW DECALS

DESCRIPTION PRICE QUANTITY TOTAL $
#116 Window Decal with "Weaver" Through Number      
One Size
 $7.00 each  __________ __________

SHIPPING & HANDLING

Please Add $5.00 S&H to your Amount Totals
$5.00

GRAND TOTAL

Please Add all Total Amounts + Shipping & Handling __________
RANDY WEAVER IS 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 D&R MOTORSPORTS & RANDY WEAVER!!!