Crime Stoppers 16th Annual Car Show Registration Agreement
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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Montana
Nebraska
Nevada
New Hampshire
New Jersey
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New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Car Make
*
Model
*
Year
*
Color
Club or organization you may belong to
Additional information about your vehicle you would like to share
Add a photo of your vehicle (Not required)
Class- check one only
*
40's and Earlier Car
Street Rod
Tri-5 (1955, 56, 57 Chevy)
50's Car
60's Car
60's Muscle
70's & 80's Car
70's Muscle
90's to Present Car
2010 - Present Modern Muscle
1970 & Earlier Truck
1971 - Present Truck
Foreign Cars - All Years
Corvette - All Years
Mustang - 1964 - 1995
Mustang - 1996 - Present
Motorcycle
Rat Rod
Open Class
"The Alias" (Highly modified, kit cars, replicas, etc.)
"The Paddy Wagon" (People Haulers, Wagons, SUVs, etc.)
"Patina and Rust" (Original Paint/Body, Rat Rods, etc.)
"Young Guns" (Participants 25 years old and under)
I understand
*
I agree that the sponsors and their respective officers, directors, employees and agents (hereinafter, the “Released parties”) shall not be liable or responsible for injury to me (including paralysis or death) or damage to my property occurring during any activities and resulting from act or omissions occurring during the performance of duties of the released parties, even where the damage or the injury is caused by negligence (except willful neglect).I understand and agree that I assume all risks of injury and damage arising out of the activities.I release and hold the “Released Parties” harmless from any injury or loss to my person or property that may result from my participation in the activities arising from the said events. By submitting this registration form I certify that I have read this release and fully understand it and that I am not relying on any statements or representatives made by the “Released Parties”.I understand that the payment for registration is a donation and is non-refundable
I understand I must pay via credit card or PayPal after submitting this form. ***If you receive an error in card processing, please try a different card
*
Please Select
Yes
Signature
*
Fees and payments
*
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Car show registration payment
$
30.00
Total
$
0.00
Submit
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