OFFICIAL ENTRY
| TO: | The “DUCKTAIL” Run | PRE-ENTRY ENDS SEPT 1 |
| P.O. Box 305 | MUST BE POSTMARKED BY SEPT. 1 |
|
| Gas City, Indiana 46933 | PRE-ENTRY FEE $25.00 (free t-shirt) |
|
GATE FEE $25.00 (weekend of show) |
Name________________________________________________________________________________
Address______________________________________________________________________________
City_________________________________________________State_________________
ZIP________
Make of Vehicle__________________________________Year_________ Model______________________
Miles Driven to Show__________________________
| Shirt Size: | SM |
MED |
LG |
XLG |
XXLG |
XXXLG |
Signature Required______________________________________________________________________
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PLEASE READ AND SIGN
Complete and mail with $25.00, CHECK or MONEY ORDER, NO CASH to: The “Ducktail” Run, P.O. Box 305, Gas City, Indiana 46933. A confirmation of entry and official number will be furnished by return mail.
ENTRY AND ADVERTISING RELEASE: In consideration of this entry, car owner and
guests agree to permit The “DUCKTAIL” Run the use of their names and pictures
of their car for publicity, advertising and commercial purposes (including
newspaper, magazines, radio, and television) before, during and after the event
and do hereby relinquish any rights whatsoever to any photos taken in connection
with the event and give permission to publish or sell or otherwise dispose
of said photographs.
All publicity and advertising rights reserved by The “DUCKTAIL” Run Rod & Custom
Show, Incorporated.
LIABILITY: In consideration of the acceptance of the right to participate, entrants, participants, spectators, by execution of this form, release and discharge The “DUCKTAIL” Run, the Town of Gas City, State of Indiana, Grant County, and their officers, directors, agents, representatives, and servants, and anyone else connected with management or presentation of the show of and from any and all known damages, injuries, losses, judgments, and/or claims from any cause whatsoever that may be suffered by any entrant to his person or property. Further, each entrant expressly agrees to indemnify all of the foregoing entries, firms, persons, and bodies of and from any and all liability occasioned or resulted from the conduct of entrants or any participant assisting or cooperating with entrant under the directors or control of entrant. WE RESERVE THE RIGHT TO REFUSE ANY ENTRY. (Sorry no refunds)
By Signing the top part of this form says that you have read and agreed to the above information.