State __________________________ Zip
Car Club affiliation __________________________________________________________
Number of vehicles __________________
at $15.00 each Total:
Additional (*optional) donation amount
Preferred Class __________________________
Display only (not judged) Y/N __________________________
_________ I am
interested in volunteering as a show judge.
By completing this registration and
participating in this event, the undersigned, or agent, agrees to HOLD
HARMLESS the National Parkinson Foundation Ohio, Quaker
Steak & Lube, any of its representatives, agents or volunteers affiliated
with the production of this event, for any injuries or damages which may
incur while participating in this event. Any and all photographs,
still or moving, taken by the National Parkinson Foundation Ohio, any of its representatives, agents or volunteers affiliated
with the production of this event becomes the sole property of National
Parkinson Foundation Ohio and may be used for future
advertising or promotions.
For preregistration please return this form and registration fee before August 16th to:
National Parkinson Foundation Ohio
2800 Corporate Exchange Dr.
Columbus, OH 43231
Copyright 2014. Parkinsons Car Show. All rights reserved.