2008 Car Show Registration Form

Saturday, September 6^th • 7415 W. 115^th Street

Registration begins at 11 a.m.

Car Show 1-4 p.m.

Name:______________________________	Phone:_____________________________
Address: ___________________________	City, State ZIP______________________
Make of Vehicle: ____________________	Model: ____________________________
Color: _____________________________	Year: _____________________________
Modifications:____________________________________________________________ ________________________________________________________________________
Release of Liability The undersigned agrees to indemnify, protect, defend and holds harmless the hosts, Village of Worth and their employees, all volunteers, their agents and all other persons, individuals, partnerships, corporations and local government agencies assisting in the hosting of this event thereto from any and all liability for injuries, damages and/or losses of any kind and in any way resulting from attendance at this and associated events. Signature:_______________________________________________________________ Guardian if under 18:______________________________________________________
5 TROPHIES AWARDED PRESIDENT’S CHOICEworth LIONS CLUB FOUNDERS BANK Chicago Ridge-Worth Chamber of Commerce Military choice DASH PLAQUES FOR THE FIRST 50 CARS GOODY BAGS and certificate FOR EVERY PARTICIPANT CONTACT LAUREN AT (708) 448-1181 FOR MORE INFORMATION www.villageofworth.com Please return to Lauren Placek, Village of Worth, 7112 W. 111^th Street, Worth IL 60482