To register, print this form and mail it with
your check as indicated below.
Momence
Chapter
AACA
Antique
Car Show Registration Form
Please Print and use a
separate form for each vehicle.
Name
_________________________________ Phone
________________ E-mail
____________________
Street
_________________________________ City
__________________ State _____ Zip _____________
Year ___________ Make _____________________
Model __________________ Class No. _______
Check One:
__ Early Registration -
$10.00
(thru Aug. 1) __ Regular Registration
(after
Aug. 1) $15.00 __ Cars for Sale - $15.00
~For the safety of motorists & pedestrians, we ask that cars arrive by 10:30 a.m. and stay on the field until 3:00 p.m.~
~AACA
regulations
require
that cars must have a functional fire extinguisher in order to be
judged.~
Please make all checks
payable
to Momence Chapter AACA. Registration fee
is non-refundable and includes two adults. Children under 12 are
free.
Mail to: Ernie Hart,
15559 E Lawrence Dr, Momence IL 60954.
For more information, e-mail edgetown5@aol.com
I hereby declare that I
release,
indemnify, defend, and hold harmless the Momence Chapter AACA, its
officers,
its members, and its directors from any liability, damage, injury,
losses,
or claims, personal or otherwise, that might be incurred or arise out
of
or in connection with this show. I also
affirm that
my vehicle(s) and/or my possessions are fully covered by all necessary
property
damage insurance. I also agree to abide by
the regulations
of the show.
Signature (required) _______________________________________________