VEHICLE REGISTRATION FORM - Dixieland Cruisersdixielandcruisers.org/images/flyers/2017 Car Show...

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VEHICLE REGISTRATION FORM Name___________________________________________________________ Spouse _______________________________ Address_________________________________________________________________________________________________ City_______________________________ State______ Zip____________ Phone (______)__________________________ Email Address _________________________________________________________________________________________ Vehicle Year____________ Make_________________________ Model_________________________________________ Domestic ________________ Import _____________________ Motorcycle __________________ Distance Entered Car Driven To Show__________ City & State _______________________________________ Club Affiliation_______________________________________________________________________ (For Club Award) Liability: Entrants and participants, by execution of this entry form, release the state of Georgia, Dixieland Cruisers, The Seed Church, or anyone else associated with the Dixieland Cruisers 29th Annual Event from any known or unknown damages, injuries, losses, judgments or Claims whatsoever that may be suffered by any entrant or participant or vehicle. Signature______________________________________________________________________ Date_______________________ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Please complete form and send check or money order to: Dixieland Cruisers, ATTN: Anita Fennell, PO Box 843, Pooler, GA 31322. Call Anita @ 912-661-2630 for registration information. Contact Richard Miller (Show Chairman) 912-661-0037 for show information. ***ABSOLUTELY NO ALCOHOL ON PREMISES*** **NO OUTSIDE MUSIC PLEASE** Broadcasting Live on 94.9fm Bring your portable radio to hear all the music and announcements SWAP MEET & VENDOR INFORMATION Bring, Swap, or Sell your used or new parts. For information please call: Brantley Webb (912-507-1376) or Joey Broussard (912-663-1298) Free Vendor Sign Up Please Call: Joey Broussard (912-663-1298) Visit Our Website: www.dixielandcruisers.org Or Like us on Facebook @ Dixieland Cruisers of Savannah

Transcript of VEHICLE REGISTRATION FORM - Dixieland Cruisersdixielandcruisers.org/images/flyers/2017 Car Show...

Page 1: VEHICLE REGISTRATION FORM - Dixieland Cruisersdixielandcruisers.org/images/flyers/2017 Car Show Flyer (Rear).pdf · VEHICLE REGISTRATION FORM Name_____ Spouse _____ Address ...

VEHICLE REGISTRATION FORM Name___________________________________________________________ Spouse _______________________________ Address_________________________________________________________________________________________________ City_______________________________ State______ Zip____________ Phone (______)__________________________ Email Address _________________________________________________________________________________________ Vehicle Year____________ Make_________________________ Model_________________________________________ Domestic ________________ Import _____________________ Motorcycle __________________ Distance Entered Car Driven To Show__________ City & State _______________________________________ Club Affiliation_______________________________________________________________________ (For Club Award)

Liability: Entrants and participants, by execution of this entry form, release the state of Georgia, Dixieland Cruisers, The Seed Church, or anyone else associated with the Dixieland Cruisers 29th Annual Event from any known or unknown damages, injuries, losses, judgments or Claims whatsoever that may be suffered by any entrant or participant or vehicle. Signature______________________________________________________________________ Date_______________________

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Please complete form and send check or money order to: Dixieland Cruisers, ATTN: Anita Fennell, PO Box 843, Pooler, GA 31322. Call Anita @ 912-661-2630 for registration information.

Contact Richard Miller (Show Chairman) 912-661-0037 for show information. ***ABSOLUTELY NO ALCOHOL ON PREMISES***

**NO OUTSIDE MUSIC PLEASE** Broadcasting Live on 94.9fm

Bring your portable radio to hear all the music and announcements

SWAP MEET & VENDOR INFORMATION Bring, Swap, or Sell your used or new parts. For information please call:

Brantley Webb (912-507-1376) or Joey Broussard (912-663-1298) Free Vendor Sign Up Please Call:

Joey Broussard (912-663-1298)

Visit Our Website: www.dixielandcruisers.org Or Like us on Facebook @

Dixieland Cruisers of Savannah

http://www.dixielandcruisers.org

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