Scenic City Car Show Registration Form
Pre-Entries Must Be Received By August 15, 2011
To Be Eligible For the $50
Cash Drawing
Send Pre-Registration & $10.00 to:
(Registration Day of the Show will be $15.00)
Scenic City Car Show
P.O. Box 322
Iowa Falls, Iowa 50126
(641)-648-4824
Name: __________________________________________________________
(PLEASE PRINT)
Address: ________________________________________________________
City: ____________________________________ State: _______ Zip: _______
E-mail address: ___________________________________________________
Club Affiliation: ___________________________________________________
Year of Vehicle: ________ Make: _____________________________________
Vehicle Class: ____________________________________________________
All Entries Must Be Licensed!
I understand that the SCENIC CITY CRUISERS, and their
employees, agents, representatives, servants, officials, sponsors, advertisers, or the
City of Iowa Falls and adjacent grounds are not responsible for any loss or injury to me
or my property, agents or employees at anytime, and from any cause on the premises of the
above events and any additional events. I
expressly release the above parties from any liability for such loss or injury and agree
to provide and pay for my own insurance. I
relinquish any rights whatsoever to any photos taken in connection with the above events
and any additional events, and give permission for use of said photographs in any manner
whatsoever to above parties. I also agree to
abide by all rules and regulations set forth by above parties. |
Signature (required): ___________________________________ Date: _______
©2011 Scenic City Cruisers