Please submit your payment below.
Select either the $25.00 Truck Only Registration or the $125.00 Truck & Dyno Registration.
Venmo @AndrewMazzaFoundation
Early Registration Pricing ends on June 1, 2022.
*Printable registration for check payments available in a lower section on this page.*
By submitting payment you acknowledge that you are accepting the terms of the liability clause. Liability Clause: In consideration for the right to participate, by execution of this form, you release and discharge Johnson College, The Circle Drive-In, and the Andrew Mazza Foundation, their officers, directors, employees, and/or anyone connected with the above of and from any and all known and unknown damages, injuries, losses, and claims from any cause whatsoever that may be suffered by any entrant, spectator, or their passenger(s) to his or her property.
By submitting payment you acknowledge that you are accepting the terms of the liability clause. Liability Clause: In consideration for the right to participate, by execution of this form, you release and discharge Johnson College, The Circle Drive-In, and the Andrew Mazza Foundation, their officers, directors, employees, and/or anyone connected with the above of and from any and all known and unknown damages, injuries, losses, and claims from any cause whatsoever that may be suffered by any entrant, spectator, or their passenger(s) to his or her property.
If you would like to register your truck via check payment, please fill out the form below and mail with your payment to:
Andrew Mazza Foundation
C/O Theresa Bandru
3 Tenth Avenue
Carbondale, PA 18407
All payments can be made out to "The Andrew Mazza Foundation".
If you have any questions please feel free to contact Dawn Ziegler at (570) 313-0369 or AndrewMazzaFoundation@gmail.com.
2022 Diesel Jam Truck Registration (pdf)
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