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Please Print out this Form, Fill It Out and Mail with Your Payment to the Address Below!

Submit One (1) Entry Form Per Vehicle - Limited to 150 Cars & Trucks
20 CLASS & SPONSOR PLAQUES
Event is Open to All Cars and Trucks - Entries limited & subject to organizer's discretion
Events held Rain or Shine - No refunds after August 1, 2008

Name:___________________________________________________________ Entry No.
Address:___________________________________________________ Work Phone:___________
City/State/Zip:______________________________________________ Home Phone:___________
Email Address:_______________________________________________
CAR INFORMATION: Year_______ Make___________ Model___________ Color___________
*Must carry liability insurance
Car Club Affiliation___________________________________________________________________________
If vendor, list all "for sale" items (must be 50% car related)____________________________________________
__________________________________________________________________________________________

Show Package @ $45 each__________
Vendor Space @ $200 or $300__________
____ Add'l T-Shirts @ $18 each__________
T-Shirt Size: S M L XL__________
T-Shirt Size: XXL & Up @ $20 each __________
Add'l Hot Rod & Harley Drawing Tickets__________

TOTAL ENCLOSED__________

By checking this box, I confirm that I have read the Release and Indemnity Agreement, and fully understand and will comply to all that is stated in the agreement.
Signature______________________________ Date____________
Please make Checks or Money Orders payable to:
International Good Samaritans

Enclose with this completed Registration and Mail to:
Box 7007
Stateline, NV 89449