Car Show Registration

Wearin' O' the Green    

 

Name____________________________________________________

 

Address__________________________________________________

 

________________________________________________________

 

Phone______________________ email________________________

 

Car Information: Make_____________________________________

 

Model______________________ Year________________________

 

Amount Enclosed_________________________________________

 

Signature________________________________________________

 

 

By signing and submitting this registration form I hold Chautauqua Cruisers, Inc.; Walton County Shrine Club; and any or all officers and members of said organizations harmless in the event of damage, theft or other loss to my vehicle or myself while in attendance at the above indicated event.

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