21^st ANNUAL NEW LOTHROP CAR SHOW REGISTRATION
EVENT DATE: July 31^st, 2010

Please print and mail with payment enclosed to:

NLDA - Car Show
P.O. Box 1
New Lothrop, MI 48460

Name

Address

City, State, Zip

Club Affiliation

Miles to Show

Year/Make/Model

Amount Enclosed

Pre-registration is $8.00 - Deadline July 25, 2010
Day of Show - $10.00

Dash plaques and goodie bags guaranteed to those who pre-register.

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WAIVER Of Physical Damage or Injury: In consideration of accepting this activity, the volunteer intended to be legally bound for themselves and their heirs, executors and administrators, Waive and Release any and all rights for any inquiries and damages they may have against the Village of New Lothrop, its Officials and the DDA and its car show committee representatives, successors, and assigns for any and all injuries or damages suffered in the connection with the activity of the New Lothrop Car Show.

Signature____________________________

Phone____________________ Age______
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____ Yes, I would like a car show T-shirt or Tank-Top at $10.00 per shirt
        (Note price for XXL & XXXL $12.00).


CIRCLE ONE:                 T-Shirt            Tank Top

CIRCLE ADULT SIZE:       S       M       L       XL       XXL       XXXL      

For more information call: Jamie Bruff (810) 247-5264

Make checks payable to:

NLDA - Car Show

P.O. Box 1
New Lothrop, Michigan 48460