“CORVETTES OF CLARKSVILLE”

CORVETTES ON THE CUMBERLAND

REGISTRATION FORM

April 17, 2010

 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: ________

2^ND 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 2^nd 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 2010-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 agrees 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:_________________