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Contact Information: <br />Name: _ <br />Address: <br />2018 Car Show Registration form <br />CAR # (office use only) <br />Phone: <br />City: State: Zip:_ <br />Email: <br />Club Affiliation (if applicable) <br />Release: In consideration of and to permit my participation in showing one or more vehicles in the Central <br />Washington Car Show and RC Car Race to be held in Ellensburg, Washington on June 30, 2018, 1 hereby <br />acknowledge and accept the risk of possible personal injury resulting from or caused by my participation in the <br />car show. I hereby acknowledge and affirm my continued willingness and desire to participate. Further, and of <br />my own free consent and volition and in consideration of my participation in the car show, I hereby agree to in- <br />demnify and hold harmless the Kittitas County, Kittitas Valley Event Center, and all other affiliated sponsors and <br />volunteers and do hereby waive claims for any and all injuries caused of action, or damages that I or my vehicle <br />or vehicles may sustain while participating in the show. By signing below, I acknowledge that I have read and <br />understood this waiver and release of liability and I am signing it voluntarily. <br />Signature: <br />Vehicle Information: <br />Year: Make: Model: <br />Fngine: Horsepower: Color: <br />Check One: <br />Date: <br />❑Unrestored ❑Stock []Modified <br />Please list any special features, options, interesting history or any other information of special interest: <br />Payment Options: <br />Entry fee is $25.00 per vehicle <br />❑Check (# ) ❑Cash ❑Credit Card <br />❑Card#^ <br />Exp. Date: V -Code: <br />Total Amount Due: <br />Please take this short, voluntary survey to help us improve the event in the future—thank you! <br />This information is used by our local lodging tax committee to determine future funding, thank you! <br />1. Are you staying overnight in Ellensburg? ❑Yes El No <br />If yes, how many nights will you be staying? <br />Are you staying in ❑ Paid accommodations ❑ With Friends/Family <br />2. How many people are traveling with you? . <br />3. Approximately, how many meals are you planning on having in Ellensburg? <br />4. How many times have you visited Ellensburg? <br />5. How did you hear about this event? (Facebook, radio, website, friends) <br />7. Do you participate in other car related events? If so, which ones? _ <br />For more information please contact: <br />Karey Connor (509) 962-7639 / 901 East 7th Ave, Suite 1, Ellensburg, WA 98926 <br />karey.connor@co.kittitas.wa.us <br />