Performance Classic Registration Page
 
Registrant Information
Online registration is available through end of day, July 10, 2019; cost is $20 per vehicle.
After that, you may register at the show for $25 per vehicle.
You can register up to 6 cars on each registration form.
Fields marked with a ** are required.
FIRST NAME: **
LAST NAME: **
ADDRESS: **
CITY: **
STATE: **
ZIP: **
PHONE:
EMAIL: **
RE-ENTER EMAIL TO ENSURE ACCURACY: **
NAME OF YOUR CAR CLUB (IF ANY):
 
Car Information
Please register at least one car. **
MAKE:


MODEL:


YEAR:

COLOR:


CLICK HERE to register another car
MAKE:


MODEL:


YEAR:

COLOR:




CLICK HERE to register another car
MAKE:


MODEL:


YEAR:

COLOR:




CLICK HERE to register another car
MAKE:


MODEL:


YEAR:

COLOR:




CLICK HERE to register another car
MAKE:


MODEL:


YEAR:

COLOR:




CLICK HERE to register another car
MAKE:


MODEL:


YEAR:

COLOR:




 
Hold Harmless Agreement
In consideration of the acceptance of the right to participate, by execution of this entry form, I hereby release and discharge Performance Classic Auto Show and all sponsors of Performance Classic Auto Show and their officers, employees, directors, agents and representatives and anyone else connected with the management, promotion or presentation of Performance Classic Auto Show from any and all known or unknown damages, injuries or losses, judgements and/or claims from any cause that may be suffered by any entrant or participant to his or her person or property. Further, each entrant expressly agrees to indemnify all the foregoing entities, firms, persons and bodies from any and all liability occasioning or resulting from the conduct of any entrant, participants or spectators assisting or cooperating with entrant under the direction or control of entrant. Further, I agree that any photos or videos of myself or my property as a result of this event may be used promotionally.
 
**   Please check this box to indicate that you have read and agree to the terms above.
 
 
Additional Donation
I would like to make an additional donation to Impact60 and The Arthritis Foundation in the amount of :
$5   $10   $25   $50   $100   Other amount (please specify): 
 
 
Payment Information
Method of payment: ** CREDIT CARD CHECK OR MONEY ORDER

To pay securely online with your credit card, you will be directed to a payment page after you submit this form.

To pay by check or money order, please make checks payable to Performance Chrysler Jeep Dodge Ram Delaware and indicate clearly the name of the registrant. Mail to:
Performance Chrysler Jeep Dodge Ram Delaware
Attn: Car Show
2815 Stratford Road
Delaware, OH 43015

You will get a summary of your registration fees, your Car Show ticket fees and your donation after you click SUBMIT.

Please note that your registration is not complete until payment is received. Registration fee is based on date of payment, not date of registration.
When you’ve completed the form, press SUBMIT

 
ALL PROCEEDS FROM THE PERFORMANCE CLASSIC AUTO SHOW BENEFIT:
 

Performance Classic Auto Show
Performance Chrysler Jeep Dodge Ram Delaware | 2815 Stratford Road | Delaware, OH 43015 | 740-369-9611 | bbrown@performancecdj.com
Copyright © 2018 Performance Classic Auto Show