Make your own free website on Tripod.com

OFFICIAL ENTRY FORM

 

My signature below confirms my intended participation in the RODDIN' ON THE RIVER car show. In consideration for participation in this event, I hereby release and discharge the RODDIN' ON THE RIVER run committee, the RIVER CRUIZERS, INC. CAR CLUB, the RIVERSIDE RESORT, the CITY of LAUGHLIN, CLARK COUNTY and the STATE of NEVADA or any officers, members, employees, agents or affiliates; from any and all known and unknown damages, injuries, losses, judgments or claims for any cause suffered by me personally or my property, as well as anyone under my direction or control. I also agree to indemnify, without consideration, reservation or qualification, all of the aforementioned persons from any and all liabilities occasioned from actions or conduct of any person assisting me, cooperating with me, under my direction or myself.

Canopies or other shade structures are my sole responsibility and must be secured at all times.

I HAVE READ AND DO UNDERSTAND THE STATEMENT ABOVE AND REALIZE THAT MY SIGNATURE HEREON LIMITS MY RIGHTS AT LAW.

       

Signature:

 _______________________________________

 Date:

__________________________
 

Name

 _____________________________________________________________________________

 

Mailing Address (P.O. Box)

 ________________________________________________________

  

City

_____________________

State

 ____

 

Zip

___________

         
Phone

_________________________

E-Mail

____________________________
 

Vehicle Year

 _____

Make

________________

Model

_________

Color

________
               

Club Affiliation 

___________________________

City

__________________

State

_____

           
Circle years of participation:  92  93  94  95  96  97  98  99  2000  2001  2002  2003 2004 2005 2006
 

 


 

ENTRY FEE $45 FOR FIRST ENTRY AND $25 FOR EACH ADDITIONAL ENTRY
OF SAME - OWNER VEHICLE

Make checks payable to: THE RIVER CRUIZERS, INC.
Mail entries no later than Sept. 15th.  After Sept. 15th, you can register at the event.
Mail entries to: RODDIN' ON THE RIVER
C/O Neal & Velma Shupe
2290 Flathead Road
Fort Mohave, AZ 86426
 

For Registration Information Call: 928-788-2174 or Email desertnv@citlink.net

For more information, call Ellen Bridges / Event Chairperson 928-505-8457

For Vendor Info, Call 928-505-8457

"RODDIN' ON THE RIVER" is a registered trade name of THE RIVERCRUIZERS, INC.. of Bullhead City, Arizona and is not associated in any way or has given permission for its use to an other club, organization, company or promotional agency.