THE 12th ANNUAL

 

St. Jude Open Car, Truck and Motorcycle Show

 

Saturday, April 17, 2010

 

Registration from 8:00 a.m. - 11:30 a.m.

 

 

Name_____________________________________________________________________

 

Address__________________________________________________________________

 

City_________________________________ State______________ ZIP____________

 

Daytime Phone ____________________Evening Phone__________________________

 

Make/Model____________________________ Year ________ Color ______________

 

 

ENTRANTS AND PARTICIPANTS BY EXECUTION OF THIS ENTRY FORM RELEASE AND DISCHARGE ST. JUDE CHILDREN'S RESEARCH HOSPITAL, BATON ROUGE CORVETTE CLUB, INC. CITY OF PLAQUEMINE AND PARISH OF IBERVILLE, THEIR OFFICERS, EMPLOYEES, AGENTS, REPRESENTATIVES AND ANYONE ELSE CONNECTED WITH THE PRESENTATION OF THIS TWELFTH ANNUAL CAR SHOW (A PLAQUEMINE MAIN STREET EVENT) FROM ANY AND ALL KNOWN OR UNKNOWN DAMAGES, INJURIES, LOSSES, JUDGMENTS AND/OR CLAIMS FOR ANY CAUSES WHATSOEVER THAT MAY BE SUFFERED BY AN ENTRANT OR PARTICIPANT TO HIS PERSON OR PROPERTY.

 

Registration Fee: $40.00

 

*******EXPRESS LANE FOR PRE-REGISTERED ENTRANTS*******

 

St. Jude Car Show 2010

c/o Jeff Travasos

212 Richard St.

Brusly, LA. 70719

 

Make payable to: St. Jude Special Account (#1603647)

 

Questions: Contact Jeff Travasos 225-749-3372 or Frank Wharton 225-769-3538