OFFICIAL ENTRY

TO: DUCKTAIL Run
PRE-ENTRY ENDS SEPT. 1st - NO EXCEPTIONS
  P.O. Box 305
MUST BE POSTMARKED BY SEPT. 1st
  Gas City, Indiana 46933
PRE-ENTRY FEE $30.00
FREE T-SHIRT WITH PRE-ENTRY ONLY
   
GATE FEE $30.00 weekend of show/NO T-SHIRT


Name________________________________________________________________________________

Address______________________________________________________________________________

City_________________________________________________State_________________ ZIP________

Make of Vehicle__________________________________Year_________ Model______________________

Miles Driven to Show__________________________

Shirt Size: SM    MED    LG    XLG    (add $2.00) XXLG (add $2.00) XXXLG

 

Signature Required______________________________________________________________________


- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -


PLEASE READ AND SIGN

Complete and mail with $30.00, 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.