REGISTRATION FORM
12TH ANNUAL CAR/TRUCK SHOWOFF - APRIL 13, 2013
OPEN DOOR CHURCH - 5701 BIRMINGPORT HIGHWAY - BIRMINGHAM, AL 35224
Email to [email protected] or fax to 205.491.5646
NAME:______________________________________________________________________________
ADDRESS:___________________________________________________________________________
CITY/STATE/ZIP:______________________________________________________________________
EMAIL:_______________________________________________________________________________
VEHICLE:________________________YEAR:__________________MAKE:_________________________
MODEL:_________________________COLOR:______________________
ENTRY DONATION: $15.00
MAKE CHECKS PAYABLE TO: OPEN DOOR CHURCH
MAIL TO: 1004 McDONALD CHAPEL ROAD
BIRMINGHAM AL 35224
LIABILITY: By execution of this form, entrants and participants agree to hold harmless Open Door Church, its officers, directors, agents, representatives, servants, and anyone else connected with the presentation of the 12th Annual Car/Truck Showoff from any and all known, or unknown, damages, injuries, losses, judgements, and/or claims from any causes whatsoever that might be suffered by any entrant or participant to their person or property.
__________________________________________________________________
Signature of Entrant
OPEN DOOR CHURCH - 5701 BIRMINGPORT HIGHWAY - BIRMINGHAM, AL 35224
Email to [email protected] or fax to 205.491.5646
NAME:______________________________________________________________________________
ADDRESS:___________________________________________________________________________
CITY/STATE/ZIP:______________________________________________________________________
EMAIL:_______________________________________________________________________________
VEHICLE:________________________YEAR:__________________MAKE:_________________________
MODEL:_________________________COLOR:______________________
ENTRY DONATION: $15.00
MAKE CHECKS PAYABLE TO: OPEN DOOR CHURCH
MAIL TO: 1004 McDONALD CHAPEL ROAD
BIRMINGHAM AL 35224
LIABILITY: By execution of this form, entrants and participants agree to hold harmless Open Door Church, its officers, directors, agents, representatives, servants, and anyone else connected with the presentation of the 12th Annual Car/Truck Showoff from any and all known, or unknown, damages, injuries, losses, judgements, and/or claims from any causes whatsoever that might be suffered by any entrant or participant to their person or property.
__________________________________________________________________
Signature of Entrant