Please print off the registration form below, complete it & mail with your entry fee payable to:

Rotary Club of Clay County, P. O. Box 916 Hayesville, NC 28904-0916

NAME: ___________________________________________

ADDRESS: __________________________________________________________

PHONE: __________________________      

Early Registration Fee $15 Per VehicleEvent Day Registration Fee $20 Per Vehicle

YearMakeModel
   
   
   

    Total Amount Enclosed: _________________

Entrants and participants will by execution of this form release Rotary Club of Clay County, their officers, volunteers Clay County City of Hayesville, their employees and volunteers, and anyone else connected with the presentation of this CAR SHOW from any and all damages, injuries, losses, judgments, or claims from any cases whatsoever that may be suffered by any entrants to his/her person or property.

Further, I understand and acknowledge the dangers associated with the consumption of alcohol and/or drugs before, during and after this event, and I fully recognize the consumption of alcohol and/or drugs might impair my judgment and/or motor skills. I hereby assume all responsibility for any loss, injury and/or damage associated with my consumption of alcohol and/or drugs. I waive, release, and forever discharge the event sponsors and all other persons involved in this event from any and all claims, liabilities of every kind, demands, damages, losses and any present and/or future causes of action that may arise out of, result from or relate to my participation in this event and/or my traveling to and/or from this event.

PRINTED NAME: _______________________________