Chevy/Vettefest Registration Form
Please print clearly, fill out completely and sign. Incomplete applications/payments will delay processing.

Choose City or Cities
March 5-7, 2010 – Donald E. Stephens Convention Center
Entry Deadline: February 5, 2010
 
Name
Address
City
 State
 Zip
Phone
 Fax
 Email


CAR SHOW (Please submit photos with registration form)
QTY:
PRICE
GOLD SPINNER CONCOURSE (For original/restored vehicles. Must include serial #)
95.00
TRIPLE CROWN (Requires valid copy of N.C.R.S. Top Flight certificate, and Bloomington Gold certificate, along with the full serial number in advance.)
$250.00

TOTAL
 
 
Model
 Year
Color
Class #
Serial Number (for Gold Spinner and Triple Crown judging)
 
 
ELECTRIC
Do you require electric hookup for space (110 volt, 15 amp outlet)?
       
Release: I accept and assume full liability for any injury or loss to me or my property, agents or employees at any time, from any cause in connection with this event. I expressly release Championship Auto Shows, Inc. (CASI) from any liability for such loss or injury and agree to provide and pay for my own insurance. I agree to let CASI sell my space, with no refunds, if I have not occupied my space with 1/2 hour of the event’s start time. I agree that I will have any belongings from my vendor/show/sale space removed from the premises with 4 hours after the show closes, after which, I agree to pay my associated costs incurred (storage fees, removal fees, etc.). I also, hereby agree to allow CASI, or its assignee’s the right to use photos of me, my exhibit, my name, and any other information regarding my participation in this CASI event, in future press releases, advertising and television, radio, magazines, newspapers, and related publications. I understand that weapons, pornographic material or any items CASI deems inappropriate, will not be permitted for sale or display. I understand that a show car may not be offered for sale unless the car sale fee has also been paid. No refunds 20 days prior to event. If exhibitor is under 18 years of age, parent or guardian must sign for exhibitor. CASI is not responsible for typographical errors or omissions on any printed material or its website.
 
Signature _________________________________________ Date _______________________
 
 
METHOD OF PAYMENT
Registration form must be fully completed and payment must accompany form for processing.
 
 
Name on Card
Billing Address (if different from above)
Card Number
 Expiration Date
Security Code # (3 numbers after account # on signature line of card)



Print this form and return it with your payment to:
(Make check payable to Championship Auto Shows. Pre-registration only.
No at-the-door registrations. No refunds 20 days prior to event.)
Ron Mroz, 5055 North Neenah, Chicago, IL 60656
(773) 763-6359; E-mail: ronklassic67@aol.com