RED LION HOTEL
- Phoenix North
(Formerly
the Ramada Plaza Metrocenter Hotel)
REGISTRATION FORM
Name____________________________________Phone_________________
Name____________________________________E-Mail/Fax______________
Address_____________________City_______________State_____Zip_____
Date of Car Show: Saturday, January
19, 2002 at the Red Lion Hotel
Judging 9:00 a.m. to
3:00 p.m.
Cars(s) entered in Concours ____________________________________________________
Year
Make
Series
____Chrysler 300 Letter Car(s)
Vin#_______________________________________________
____Non-Letter Car(s)
_____Mopar Class
General Meet Registration @ $25.00
per family
$_____________
Judging (first car included in
registration) Additional Car $8.00 each X___$_____________
Friday Jan. 18 Western Beef BBQ
Poolside Dinner @ $18.00 each X___$_____________
Saturday Jan. 19 Awards Banquet
@ $25.00 each (Select below)
X___$_____________
__Grilled Salmon Florentine __Brandied
Apple Stuffed Pork Loin __Cajun Grilled NY Steak
TOTAL $____________
Mail completed form and check (payable
to Chrysler 300 Club, Inc.) to:
Chrysler 300 Club, Inc., Gerry
Steinberg, 3788 Mohawk Drive,Sierra Vista, AZ 85650-8957
RELEASE FORM
I agree to insure my vehicle and property against loss, damage and liability. I agree to assume the risk of any and all damages of injury, and to indemnify and hold harmless the Chrysler 300 Club, Inc., its officers, directors, agents and employees for any acts of omission which may result in the theft, damage or destruction of my property or injury to me or others occurring during or as a consequence of this Meet, wherever located.
Signature____________________________________________________Date__________________________________