Car Show Registration Form - Veterans Count

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Saturday, Oct. 1, 2016 from 2pm-5pm
CAR SHOW REGISTRATION FORM
Please fill out this form and bring it with you to the car show on Saturday, October 1st.
Please note the entry fee is being waived in this inaugural year.
ALL CAR SHOW REGISTRANTS WILL BE ENTERED
INTO A SPECIAL RAFFLE!
Owner Information:
Name: _____________________________________ Car Club: ___________________________
Address: ________________________ City: _________________ ST: _______ ZIP:___________
Phone: _____________________________ E-mail: _____________________________________
Vehicle Information:
Year: _________________________
Make: ________________________
Model: ________________________
Color: ________________________
Suggested Donation $15
Please accept my donation to Veterans Count
I do not wish to support Veterans Count
Check enclosed
Please charge my credit card: #: __________________________ Exp.________ CVC:________
REGISTRATION OPTIONS:
ONLINE:
Official Use Only
PHONE: (603) 621-3570
FAX: (603) 625-1148
Car #

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