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“CORVETTES
OF CLARKSVILLE”
CORVETTES ON THE
CUMBERLAND
REGISTRATION
FORM
April 21, 2012
For
Pre-registration mail to: Corvettes of
Clarksville
,
PO
BOX 20056
,
Clarksville
,
TN
37042
NAME:
_______________________________________________________________
ADDRESS:
____________________________________________________________
CLUB AFFILIATION/LOCATION:
_______________________________________
E-MAIL
ADDRESS:_____________________________________________________
YEAR/COUPE
OR CONVERTIBLE:
___________COLOR: ___________________
2ND
CAR IF ENTERED: ______________________________COLOR: ___________
*** Your registration grants Corvettes of Clarksville
the right to use picture(s) of you and your car on their web-site.
Early
entry-pre-registration is: $20 per Corvette (Pre-registration will also help
us to plan parking) ENTRY FEE: $25 per car day of the show, $20 for your 2nd
entry
All entries will receive a T-shirt at no extra cost, additional T-shirts are $10
per shirt. T-shirts are white with the 2012 show logo for the event.
Please specify shirt size:
Circle
one- XXL XL
L M
SM (If purchasing extra shirt please state size:
________)
Hold
Harmless Agreement
Must
be signed by all car owners
Entrant agrees to carry his/her own comprehensive
and liability insurance. Entrant
assumes full responsibility for any loss or damage from fire,
theft or accidents. Entrant further
agrees to abide by all of the events
rules and regulations and that Corvettes of Clarksville shall have the final say
in all matters. All fees and
payments are not refundable. Entrants
agree that Corvettes of Clarksville shall not be responsible or liable for any
loss or damages of any kind suffered by the entry during this event.
Signature:
____________________________________________Date:_________________
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