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30th ANNUAL LAKE GENEVA |
(Print form and mail to address below) |
Name:__________________________________________________________ |
Address:________________________________________________________ |
City:______________________State:___________Zip:___________________ |
Phone:__________________________________________________________ |
For car club or multiple registrations, please photocopy this release form and have each participant sign a copy and submit with registration for exact number of admission passes. One pass for each signed form only. Email address:____________________________________ Please list year and make of car(s) on the reverse side of this form. |
WAIVER: ENTRANT'S CONSENT (Must be read, understood and signed) In consideration of my participation in the 2007 LAKE GENEVA CLASSIC CAR RALLY to be held on September 28 & 29, 2007, I do hereby, upon my signature, agree to hold free from any and all liability the CORINNE KREISSL MEMORIAL FOUNDATION, THE AMERICAN CANCER SOCIETY, THE LODGE AT GENEVA RIDGE, THE LAKE GENEVA ROTARY CLUB, THE LAKE GENEVA CHAMBER OF COMMERCE and the organizers and volunteers, and do hereby for myself, heirs and executors and administrators waive, release and forever discharge any and all rights and claims for illness, injury and damages which I may have or which may hereafter accrue to me arising out of or connected with my participation in this event. The car I will be riding in is covered by liability insurance. I also understand and agree that any sponsor may subsequently use for publicity and/or promotional purposes my name and/or pictures of my participating in this event without obligation or liability to me. ______________________________________________ |
ADVANCE REGISTRATION |
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| I (we) will play | (_____) 3 hands for $20. |
| (_____) 7 hands for $40. | |
Hands purchased in |
(_____) 12 hands for $60. |
advance are all valid. They |
(_____) 25 hands for $100. |
will be played by proxy if |
(_____) 60 hands for $200. |
not picked up. |
(_____) 100 hands for $300. |
Pre-registration by mail by
September 21, 2007 or in person ONLY on Saturday September 29 to 6:00 p.m. Send check or money order to: American Cancer Society Participants must sign attached waiver. All registration donations are tax deductible. Winners must be at least 21 years old. |
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Copyright © 2007 Classic Car Rally