Please Fill Out Form Below, Print It and Send it Via Snail-mail or Fax 

Our Fax number is (661) 944-2348

Open to Pre 1973 Vehicles Only Please (No year limit on special Interest vehicles, and Kustom Built, Bikes)

Please Read Carefully

We will be accepting Vehicle Registration the Day of the Show.... Fill out the Registration form Below and bring it with you. Pay via Cash only at the Gate. All Registered Vehicles will be judged as long as you register by 9:30 am so get in the line early !!!!!!!!!

Car Show Entry Form

1 Make..

 

2 Model..  

 

3 Year.. 

 

Vitals
1 Your Name..... 
2 Club Affiliation.
3 Address.......
4 City............ 
5 State
6 Zip
7 Fone
8 Fax
9 E-mail...
If paying bu Credit Card Please put your information below
Credit Card Number
EXP.

 

 

 

 

 

 

 

 

 

 

Please Select Class Of Choice By Checking The Appropriate Box

 

100 Stock 1900-1934 200 Modified 1900-1934 & T-Buckets
300 Modified 1900-1934 Old School Chopped, Channeled, etc. 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
2100 Motorcycle  2200 Motorcycle Special interest  (No Year Limit For Self Built or Kustom)
2300 Trike all( No Year Limit For Self Built or Kustom) 2300-A Side Car ( No Year Limit For Self Built or Kustom)
2400 Scooter (No Year Limit For Self Built or Kustom) 2500 MiniBike (Stock)
2500-A MiniBike (Self Built or Kustom) 2600   Bicycles (No Year Limit For Self Built or Kustom)

2700  "Hot Rod Race"  

Note: This is a new class for cars as long as it was built to be raced. Body Style has to be either Kustom or Pre 1973 Can be Street legal. 

2800  "Kit Car or Reproductions"  

Note: This is a new class for Kit Cars or Reproduction cars.  Body Style has to be either Kustom or Pre 1973 

All Entries Must Arrive Between 7:00-9:30 am Saturday June 12th 2004 Rain or Shine....  20915 Osborn St. Canoga Park, CA 

No Burn Outs !

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 5th annual Rat Fink.Party / Kustom Kulture Extravaganza, Klassic and Kustoms Show Saturday June 12th, 2004.

Signature _________________________ Date ___________ 

 

Make Checks Payable To:

@utomated Entertainment

P.O. Box 1079
Little Rock, CA 93543

Fax (661) 944-2348

We Also Accept The Following Credit Cards Please Call for More Information and To Make Card Payment

(800) 880-6567 or (661) 944-2299

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Copyright 2000/2001/2002/2003/2004 @utomated Entertainment Little Rock, CA 93543