1 Make.. |
2 Model.. |
3 Year.. |
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1 Your Name..... |
2 Club Affiliation. |
3 Address........ |
4 City............ |
5 State.......... |
6 Postal Zip..... |
7 Telephone......
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8 Facsimile...... |
9 E-mail......... |
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Please Select Class Of Choice By Checking The
Appropriate Box
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100 Stock 1900-1934 |
200 Modified 1900-1934 & T-Buckets |
300 Modified 1900-1934 Old School Chopped, Channeled, and
Sectioned |
400 Stock
1935-1948 |
500 Modified 1935-1948 |
600 Stock 1949-1959 |
700 Modified 1949-1959 Old School Lowered, Chopped Etc. |
800 Stock 1960 - 1972 |
900 Modified 1960 -1972 Lowered etc. |
1000 Sports Car All |
1100 Truck Stock All |
1200 Truck Modified All |
1300 Muscle Car All |
1400 Special Interest/Kustom
No year Limitation |
1500 Custom Car 1940-Up |
1600 VW All
|
1700
Station Wagon |
1800
Delivery, Van |
1900
Hearse, Ambulance, Service Vehicle |
2000
Under Construction All Must Be
Der'ivable
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2200 .Motorcycle
Women's Class No year Limitation
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2400 Scooter |
2500 Minibike |
2600 Bicycles |
2700 Motorcycle
Special Interest/Kustom
No year
Limitation |
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All Entries Must Arrive Between 7:00-9:30 am Saturday
July 20th 2002 Rain or Shine.... 20915 Osborn St. Canoga Park, CA
Liability
Release: By execution of this form, I do hereby release and discharge the City of Canoga Park CA, Ed Roth Estate, Moldy Marvin, Elks Lodge # 2190, West Coast Kustoms, Galpin Ford, Automated Entertainment, Kulture Shoq, The
Mutilators Motor Club, and any members or employees
thereof for any injuries to myself and all damages that may occur to my vehicle or
vehicles while I am participating in Moldy Marvin's 3rd annual Rat Fink.Party / Kustom Kulture Extravaganza, Klassic and Kustoms Show
Saturday July 20th, 2002.
Signature
_________________________ Date ___________
We Also Accept The Following Credit Cards Please Call for More
Information and To Make Card Payment
(800) 880-6567 or (818) 767-0222
Copyright 2000/2001/2002 @utomated Entertainment Burbank, CA
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