COON LAKE CLASSIC CAR SHOW

PLEASE PRINT ON FORM

CAR SHOW REGISTRATION FORM ENTRY# _______________

OWNER/PARTICIPANT NAME:__________________________________________

ADDRESS:____________________________________________________________

CITY:____________________________STATE_______________ZIP____________

YEAR:______________________ MAKE:_______________________________

MODEL:________________________________________

COLOR:________________________________________

MODIFIED: YES___________ NO_______________

CLUB AFFILIATION: YES__________ NO___________

NAME OF CLUB:________________________________________

HOW DID YOU HEAR ABOUT TODAYS SHOW:___________________________________

HOW MANY MILES DID YOU DRIVE TODAY:___________________________________________

BY SIGNING BELOW, YOU ACCEPT RESPONSIBILITY FOR YOUR VEHICLE AND YOURSELF. YOU RELEASE FROM LIABILITY THE CITY OF FREDERIC, THE VILLAGE PARK AND THE CAR SHOW ORGANIZERS.

OWNER/PARTICIPANT SIGNATURE_____________________________________________

EMAIL ADDRESS: ____________________________________________________