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2018 Car Show Registration form <br />CAR # _______ ,(office use only) <br />Contact Information : <br />Name: ________________ Phone : ____________ _ <br />Address : ______________________________ _ <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 , I 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 : __________________ Date : _____ _ <br />Vehicle Information: <br />Year: ____ Make : ____ Model : _____ _ <br />Engine: ____ Horsepower: ____ Color: <br />Check One: <br />DUnrestored DStock DModified <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 />DCheck (# ___ ) DCash DCredit Card <br />DCard # ____________ _ <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? DYes ONo <br />If yes , how many nights will you be staying? __ <br />Are you staying in D Paid accommodations D 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, friend s) _____________ _ <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 />ka rey.connor@co.kittitas.wa .us