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Personal Registration: Name:_______________________________________________Spouse:___________________________________ Friend / Other: __________________________________________________________________________________ Children’s names ( if attending):____________________________________________________________________ Address:_______________________________________________ City:___________________________________ State:______________________________ Zip:________________ Day Phone:__________________________________ Evening Phone:_____________________________________ Club Affiliations:_________________________________________________________________________________ E-Mail address__________________________________________________________________________________ Homepage: http://www.___________________________________________________________________________ Number of People in your party that will be attending? ____________ Car Registration: ( One form required per car ) Year: ___________ Model: ____________ Color: _____________ Engine: __________ Transmission:_____________ Special Features: ________________________________________________________________________________ Free Event T-SHIRT SIZE: ( circle one ) M L XL XXL XXXL 4XL 5XL Additional shirts may be purchased for $10.00 each. M QTY:______ L QTY _____ XL QTY _____ XXL QTY ______ XXXL QTY ______ 4XL QTY ______ 5XL QTY Banquet Fee is $25.00 per person. How many paying guests in your party for the banquet?________________________ Pre-Registration Fee: $40.00 per car entered. Includes a lap of the track, Picture of your car at the Start/Finish Line (The Famous Bricks!), 1 Free Event T-shirt, Event Dash plaque, and a Special Event Souvenir. PRE-REGISTRATION FORMS MUST BE POSTMARKED BY AUGUST 15, 2008. REGISTRATIONS RECEIVED AFTER THE CUT-OFF DATE AND AT THE SHOW WILL BE $50.00, PER CAR ENTERED. Please make checks payable to the: Central Indiana Camaro Club Inc. Total amount enclosed(Please include one check for both Banquet and Show Fees): $____________________________ Hotel selections: http://www.indycamaro.com/Indy08/index.htm
Please complete this form and return to: Central Indiana
Camaro Club Entrants and guests, by signing this form, release and discharge the CENTRAL INDIANA CAMARO CLUB INC., GENERAL MOTORS CORPORATION, CHEVROLET DIVISION, THE INDIANAPOLIS MOTOR SPEEDWAY CORPORATION, CLARIAN HEALTH / RILEY CHILDREN'S HOSPITAL, and anyone else connected with the management of this event, from any known or unknown damages, losses, injuries, judgments and from any causes suffered to the entrant, guest and his/her vehicle or personal property. In consideration of this entry, the owner, spouse and guests agree to permit the CENTRAL INDIANA CAMARO CLUB INC and GENERAL MOTORS CORPORATION, CHEVROLET DIVISION or it’s assigns, the use of their names and pictures of the entered vehicle for publicity, advertising and commercial purposes ( including newspapers, magazines, radio and television ) before, during and after the event and do hereby relinquish any rights whatsoever to any photos taken in connection with the event and give permission to publish or otherwise dispose of said photographs to THE CENTRAL INDIANA CAMARO CLUB INC., GENERAL MOTORS CORPORATION, CHEVROLET DIVISION or it’s assigns. All publicity and advertising rights are reserved by the CENTRAL INDIANA CAMARO CLUB INC., GENERAL MOTORS CORPORATION, CHEVROLET DIVISION or it’s assigns. Signature of entrants and/or guest(s) listed above: __________________________________________________________________________Date:_______/______/_______ Signature of entrants and/or guest(s) listed above: __________________________________________________________________________Date:_______/______/_______ Signature of entrants and/or guest(s) listed above: __________________________________________________________________________Date:_______/______/_______ Signature of entrants and/or guest(s) listed above: __________________________________________________________________________Date:_______/______/_______ |