NOSTAL;,EIA .CAR CLU B PRESENTS

The 5th Annual Fun Run and: show at Yuma East Country Club

All proceeds go to Hospice of Yuma & Humane Society

PRE-REt] t SIftAT I {]N REiltJ Ift Et]

lleadline for registration* is Jlouember l"t' 20ll*IIo sign ups day of showRegistrations must be mailed to; Nastalgia Car Club, P,0. Box 25835, Yuma, Arizona, 85367

[lAIE: Sahrrday Nw. 19, 2011

TlttE: 230 am, - 9:30 am. regilsffiion

FU|t RUt{ START: 10s+1 S. Frontase Rd.

(Nnt h Big-0 Tires in the tuohills)

$30,m per curple (1 rrehide 2 lunch tidcb, T-Shi0

$15.00 g ddfltional vehide

Erta T-ShirI il5 0A iTShirt sizes Small-X-Large fi1700 XX-Large XXX Large)

Extra Lunch Tickets can be purchased at show

John Cornelius (308) ffiA-7440, Paul Sundell (928) 342-3814 or Denny Sheredy (928) 941-1497

COtJESII{]NS?

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stWaiverthe undersigned agrees to hold hanntess ke Nastalgia Car CtrJb, Yutnatast and any of its affrliabd {eEe$enhtves, sponnrs or vafunteen innected wik th'

e{eni for any ano all injuies or damages tlpt may incur while padjcipating in kis elent

Please Print

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AI] UftESS

l/Ll"lICLE YEAft: I'IA|(E:

Signature of participant or parent if under 18:

T-Shirt Size I Small Qty.-I Medium Qty.--D Large Qty.::*flX.Large Qty'...:F XX Large Qty.--I XXX-Large Qty.--

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