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for the Last Fling 'Til Spring Car Show
Sept. 16, 2012
You MUST pre-register!
First 750 entries received by Sept. 12, 2012 will qualify. No class changes or substitutions
will be allowed after Sept. 12, 2012.
Please print this page and mail it along with your entry
fee to the address below.
Name:_________________________________________________________
Address:____________________________ City:________________________
State:__________ Zip:____________ Phone #: _________________________
Email:__________________________________________________________
Vehicle Info
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Be sure to fill in class number: |
CLASS
NO.:_______________ |
Click on the link below to find your class.
Judging Classes
Year:_______
Make (Chevy, Ford, etc):___________________
Model (Impala, Mustang, etc.):____________________
Style (2 dr. Hardtop, Fastback, etc.:_____________
Exterior Color:_____________________
Stock or Modified, etc:_____________________
(No trailers will be allowed in the show area. Car must be driveable. The car you pre-register
must be the vehicle you bring to the show - no substitutions allowed. You must check in by noon.)
(Entry is $20.00 per vehicle. Make payable to "Last Fling 'Til Spring")
Total for entry fees: $______________
Total for T-Shirts: $______________. (T shirt order form is on Page 2)
Total Amount Enclosed: $________________
Date:_____________________________________________
Your Signature:___________________________________________
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Mail form to the address below no later than September 12, 2011
Road Gems, Inc. Car Club
P.O. Box 101
West Point, NE 68788
Your registration will be acknowledged by return mail or your check returned.
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Official Last Fling 'Til Spring T-Shirts
Pre-Order Form A lot easier than standing in a line a block long!
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T-shirts can be picked up at check-in on day of show
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Quantity
_____S _____M
_____L _____XL ($12.00 each)
_____2XL _____3XL ($14.00 each)
_____4XL _____5XL ($20.00 each)
(Price includes tax. Please include in same envelope with registration and designate
number of t-shirts and sizes.)
Info:
Fritz Feyerherm: Phone (402) 372-6469 (Nights after 6 pm and weekends)
Vendor Info:
Doug Peterson: Phone (402) 372-3390 (Weekdays - 8 a.m. to 5 p.m.)
Questions on registration information:
Jay & Bonnie Vogltance (402) 372-3805 or (402) 380-2498. (Nights after 6 pm and weekends)
Liability : In consideration of the acceptance of the right to participate, entrants,
participants and spectators by execution of the entry form, release and discharge the city
of West Point, Road Gems, Inc. and its officers, directors, employees, agents,
representatives and servants and anyone else connected with management
or presentation of
this event and all event sponsors and participants of and from any and all damages,
injuries, losses, judgments, and/or claims from any cause whatsoever that may be suffered
by an entrant to his or her property, further, each entrant expressly agrees to identify
all the foregoing entities, firms, persons and bodies of and from any and all liability
occasioned or resulting from the conduct of entrants or any participant assisting or
cooperating with the entrant under the direction or control of the entrant.
All material is � 2011 by
Road Gems Car Club, Inc.
Any copying, redistribution or re-transmission of the contents of
the service without the express written consent of The Road Gems, Inc. is expressly
prohibited.
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