1. NAME OF OWNER:
2. NAME OF DRIVER:
3. ADDRESS:
4. CITY & STATE:
5. ZIP:
6. DAY PHONE:
7. NIGHT PHONE:
8. CELL PHONE: 9. E-MAIL ADDRESS:
10. YEAR:
11. MAKE:
12. MODEL:
13. LICENSE PLATE NUMBER:
14. A DESCRIPTION OF YOUR VEHICLE:
15. COMMENTS ABOUT CRUZ NITE:
TYPE YOUR NAMES (Owner 1st box, Driver 2nd box) TO SIGN THIS APPLICATION
AND CERTIFY THAT YOU HAVE READ THE BELOW STATEMENT!
*I ,
certify that I have read all the RULES
for the Selah Community Days Cruz Nite and agree to abide by them. My signature
indicates my understanding of these rules and indicates a desire to participate
in this event. All members of my organization taking part in this event
have been notified of these rules. In consideration of the acceptance of
our entry, the sponsor and/or Cruz Nite Participant(s) named herein, here-by
indemnify and hold harmless the Selah Community Days Association, City
of Selah, and their Officers, Volunteers, Chairman and
Employees, from any claim or demand for personal injury, death or property
damages which arise through or in connection with the sponsors and/or
Cruz Nite Participant's, Participation in the Selah Community Days Event!
I grant permission for all of the foregoing to use any photographs, motion pictures,
recordings or any other record of this event for any legitimate purpose.
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