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Entry Form – Please
print, then detach and mail.
Mail entry form to:
“Bridge City Cruisers”, PO Box 791,
Valley City ND 58072.
NAME:
___________________________________________ Spouse/Guest
________________________
ADDRESS:
____________________________ CITY/STATE/ZIP:
_______________________________
E-MAIL:
_________________________________ PHONE:
_____________________________________
VEHICLE
YEAR: _______ MAKE: ___________________ MODEL:______________________
NDSRA
#_____________
Entry
Fee: Before June 1st$20.00, After June 1st $25.00/2 vechicles allowed.
Additional vehicles by same owner $5.00/vehicle!
TOTAL AMOUNT ENCLOSED: $ _____________________________
Liability:
In consideration of the acceptance of the right to participate, entrants,
participants, and spectators by execution of this form, release and discharge
Bridge City Cruisers Car Club and its officers, directors, representatives,
members, and anyone else connected with the management or presentation of
this event of and from any and all damages, injuries, losses, judgments,
and/or claims from any cause whatsoever that may be suffered by an entrant
or to his or her property, further each entrant expressly agrees to
indemnify all the foregoing entities, firms, persons, and bodies of and
from any and all liability occasioned or resulting from the conduct of
entrants of any participation assisting or cooperating with entrant under
the direction of control of entrant.
Signature:
____________________________________________ Date _____________________
Thanks! You will have an information packet waiting for you at
the registration desk when you arrive at the show. Motel information is on
the back of this form. |
