 |
Texas Model A Ford Club
|
|
Name: ________________________________________________________ Spouse: ___________________________________ Address: ______________________________________ City: ______________________________ State: ____Zip:____________ Phone: ___________________ Club Affiliation: ______________________________ Driver’s Name_________________________ Email address for correspondence: ________________________ Names and ages of minor children attending: _________________ ALL REGISTRATION CONFIRMATIONS WILL BE SENT VIA REGULAR MAIL SERVICE Model A you are bringing: Year _______ Body Style: ________________Would you like your car judged? YES___NO___ Do you need an Era Fashion judging form? YES___ NO ___ Hotel where registered: _____________________________ Will you be racing a car in the Hubley Derby? YES___ NO___
MAKE CHECKS PAYABLE TO “42nd TEXAS TOUR” ********** NO REFUNDS AFTER MAY 15TH ********** REGISTRARS: Xyz TOUR CHAIRMEN: Xyz I HEREBY RELEASE THE MODEL A FORD CLUB OF AMERICA INC. AND THE LONE STAR MODEL A FORD CLUB FROM ANY AND ALL LIABILITIES. SUBMITTAL OF THIS REGISTRATION FORM WHETHER SIGNED OR UNSIGNED CONSTITUTES ACCEPTANCE OF THIS RELEASE. Signature: ___________________________________________________________________ Date:________________________ |
|
|
