Registration form MUST INCLUDE a minimum of TWO (2) color photographs (in display if possible), one front 3/4 view and one rear 3/4 view. NO exceptions.
Please
print this form and return it with your payment to:
( make checks payable
to: C.A.S.I )
Tom Culbertson
5242 W. Naomi Street
Indianapolis, IN 46241
(317)227-0413
INDIANAPOLIS, IN - 2012
MOTORAMA ENTRY FORM
500 World of Wheels February 10-12, 2012
Indiana State Fairgrounds
Please
fill out this form completely, print and mail to
the address below AS SOON AS POSSIBLE. Please submit your application early to assure
acceptance, as space is limited and we are sure
to sell out.
My
Entry will require an electrical outlet (Fee paid
at move-in)
MOTORAMA Entry Fee
$30.00
Fee after January 1, 2012 is $40
TOTAL ENCLOSED
Name
Age
Day
Phone Eve.
Phone
Email
Address
City
State
/ Prov.
Zip
Year
of Vehicle Make
Body
Model
Display
Size
Will
Your Entry Be Part of a Club Display?
Club Name:
Move In Time Preference
________________________________
_____________
Signature
Date
(if
exhibitor is under 18 years of age, parent or
guardian must sign for exhibitor.) I agree to
the rules and regulations stated herin.