Bellevue
Washington July 27-29, 2007 |
Download this document as an Adobe Acrobat file (pdf format)
Please complete all information on form and then print completed form. Sign the completed and printed form, then send/fax to address/fax# at bottom. To qualify for the Early Entry Drawing your entry must be post marked or faxed by June 28, 2007 Name
__________________________________________________ Vehicle Information (Classes will be determined by number of entrants)1 st Vehicle entry will receive a Dash Plaque, Souvenir Program with Pre Registration Only. Pre-Registration deadline is Wed. July 25, 2007Make, Year, Model, Color, Body Style 1_________________________________________________________ Regalia ( Enter Qty)Tshirts M ___________L__________ XL__________Tshirts XXL__________ XXXL_________ Fees Item Qty Price Sub-Total First
Vehicle
____________
$30.00
____________ TOTAL ______________________ I agree to insure my vehicle against loss, damage, and liability. I agree to assume the risk of any damage or injury, and to indemnify and hold harmless The Puget Sound British Automotive Society, its officers, and directors or agents for any acts of omission which may result in the theft, damage, or destruction of my property or injury to me or others occurring during or as a consequence of this meet including but not limited to: overnight storage, and all places associated with this meet. Signature:______________________________________Date:_____________ Payment Method All payment must be in US Funds. Please make checks payable to Puget Sound British Automotive Society (PSBAS) Mail printed form to Arnie Taub 17610 NE 8 th Place Bellevue WA 98008 Your Entry Form & Credit Card information can be sent by FAX to: (425) 747-0205Check
Visa____ Mastercard____ There will be no refunds or cancellations within 14 days of the event. All entries received prior to July 1st will be confirmed.
|
|
Spit-together Home |
Site:North American Spitfire Squadron all material copyright© 1998-2009 Site graphics, scripts, site design copyright© Teglerizer 1998-2009 |